[2] Venous stasis may occur at the end of the first trimester, due to enhanced compliance of the vessel walls by a hormonal effect.
[5] The study included women admitted to hospital for one or more days for reasons other than delivery or venous thromboembolism.
[7] This can in turn lead to complications like early-onset hypertensive disorders of pregnancy, pre-eclampsia and small for gestational age infants (SGA).
[8] Deep vein thrombosis has an incidence of one in 1,000 to 2,000 pregnancies in the United States,[2] and is the second most common cause of maternal death in developed countries after bleeding.
[13] A blood test including platelets and a clotting screen should be performed prior to administration of anticoagulant regimens in pregnancy.
[13] While unfractionated heparin is otherwise typically given in an intravenous formulation, this is inconvenient for the prolonged period of administration required in pregnancy.
In a recent retrospective analysis, resumption of warfarin after the first trimester is completed is associated with increased risk of loss of the fetus.
[21] Prevention of DVT and other types of venous thrombosis may be required if certain predisposing risk factors are present.
[9] A total of two points indicates short-term prophylaxis, e.g. with LMWH, may be used in temporary risk factors, as well as administering prophylactic treatment seven days postpartum, starting a couple of hours after birth.
[9] A previous distal DVT indicates a minimum of 12 weeks (three months) of therapeutic anticoagulation therapy.
[9] All anticoagulants (including LMWH) should be used with caution in women with suspected coagulopathy, thrombocytopaenia, liver disease and nephropathy.
[13] LMWH therapy does not affect the prothrombin time (PT) or the INR, and anti-Xa levels are not reliable.
[13] Both anti-IIa and anti-Xa activity may return up to three hours after protamine reversal, possibly due to release of additional LMWH from depot tissues.