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Deep vein thrombosis in pregnancy. Deep vein thrombosis (DVT) is a serious condition where a blood clot forms in a deep vein in the body, usually in the leg. If the clot breaks off into the bloodstream, it can block a blood vessel in the lungs. This is called a pulmonary embolism and needs emergency treatment.
- Overview
- Symptoms
- Is it a muscle cramp or a symptom of DVT?
- Pulmonary embolism vs. DVT
- When should you see a doctor?
- Diagnosis
- Treatment
- Effects on the baby
- Other complications
- Risk factors
The changes that happen in the body during pregnancy can cause blood clotting. The risk of deep vein thrombosis (DVT) is low, but symptoms may include swelling, pain in one leg, skin warmth and discoloration, visibly enlarged veins, and puffiness.
Deep vein thrombosis (DVT) is a blood clot that develops in a deep vein in the:
•leg
•thigh
•pelvis
•upper extremities, like the arms (less frequently)
The most obvious symptom of DVT is swelling and heavy pain or extreme tenderness in one of your legs. Approximately 82% of DVT cases in pregnancy occur in the left leg. Other symptoms of DVT can include:
•pain in the leg when standing or moving around
•pain in the leg that worsens when you bend your foot up toward your knee
•warm skin in the affected area
•visible veins that appear enlarged
•discoloration or red skin at the back of the leg, typically below the knee
You may experience muscle cramps during pregnancy. They typically affect the calf during the second and third trimesters, particularly at night. Muscle cramps during pregnancy are not a medical emergency.
They can be prevented or relieved with:
•stretching and movement
•hydration
•massages
•magnesium supplements
A pulmonary embolism (PE) is a blood clot that travels to the lungs. DVT commonly causes it. PE is rare during pregnancy but more common compared with people who are not pregnant. Symptoms of PE can include:
•sudden shortness of breath
•chest pain or tightness in the chest
•a cough that produces blood-streaked sputum (mucus)
See a doctor as soon as possible if you suspect DVT. Diagnosed DVT is not a medical emergency and is unlikely to harm you or your baby unless there are serious complications. It’s best to get checked early to begin DVT treatment.
It’s not always easy to diagnose DVT in pregnancy from symptoms alone. A doctor may order multiple tests to confirm the diagnosis, including:
•D-dimer test: This blood test identifies pieces of a blood clot that have broken off into your bloodstream. D-dimer levels above a certain threshold may indicate a higher risk of PE, but doctors typically conduct further testing because levels normally fluctuate during pregnancy.
•Doppler ultrasound: This scan determines how fast blood flows through a blood vessel. A Doppler ultrasound helps a healthcare team establish whether blood flow is slowed or blocked, a possible sign that indicates a blood clot.
•Venogram: If a D-dimer test and ultrasound cannot confirm a DVT diagnosis, a doctor may use a venogram or magnetic resonance imaging (MRI). A venogram involves injecting a liquid called a contrast dye into a vein in your foot. The dye moves up the leg. The dye shows on an X-ray, which pinpoints a gap in the blood vessel where the clot stops the blood flow.
A doctor can form a treatment plan if you develop DVT during pregnancy. They may refer you to a specialist, such as a hematologist (blood specialist) and a maternal medicine or obstetric medicine specialist.
To treat DVT, a doctor may recommend once or twice daily injections of the blood-thinning agent low-molecular-weight heparin. This treatment may help to:
•stop the clot from getting bigger
•help the clot dissolve in the body
•reduce the risk of further clots
You’ll likely have regular checkups and blood tests to ensure the clot dissolves and no further clots appear.
DVT during pregnancy typically does not affect the baby unless there are serious complications. Doctors and researchers consider heparin safe to use during pregnancy because it doesn’t cross the placenta, so there is no risk to your baby.
Depending on your anticoagulation regimen, you must stop taking injections as soon as you begin labor, or at least 12 to 24 hours before inducing labor or a planned cesarean delivery.
If you want to nurse your baby, you will have to stop the injections after birth. For those with a mechanical heart valve, a doctor may prescribe warfarin (Jantoven) to ensure the baby’s blood doesn’t thin.
This medication carries significant risks for you and your baby, particularly before birth. Fetuses exposed to warfarin may develop congenital disabilities.
Untreated, DVT can have lasting effects on the body.
•Long-term DVT can lead to permanent swelling of the veins and fluid retention.
•In rare cases, a clot can dislodge and move to the lungs, resulting in a PE.
•Another rare complication from DVT is venous gangrene of the toes or fingers.
•Irreparable damage to the veins from DVT may result in chronic post-thrombotic syndrome. This is a collection of symptoms associated with leg pain and ulcers.
Finally, taking anticoagulants raises the risk of side effects like bleeding. Report any unusual bleeding, such as nose bleeds, bloody stool/urine, or bruising, to a doctor if you take these medications.
Factors that can increase your risk for DVT during pregnancy include:
•having a previous history of clots or DVT
•having a family history of DVT
•being over 35
•having a BMI of 30 or higher
•carrying twins or multiple babies
- Claire Gillespie
A deep vein thrombosis (DVT) is a blood clot that forms in a deep vein of the leg, calf or pelvis. Pregnancy increases your risk of a DVT, with the highest risk being just after you have had your baby. However, venous thrombosis is still uncommon in pregnancy or in the first 6 weeks after birth, occurring in only 1-2 in 1000 women.
A DVT can cause blockage to the flow of blood in that vein which can cause pain, swelling and discomfort in the leg. A DVT can be serious because part of the blood clot (embolus) can break off and travel up the vein, through the heart and into the lungs. The clot can then lodge in the blood vessels in the lungs and block the circulation of blood.
chine is used to look for clots in the blood vessels of your legs. This is. ve technique, and is usually not painful to carry out.Other scans• Sometimes. a blood clot can form higher up, such as in your groin or abdomen. This is more common during pregnancy and in the postnatal period. If the do. tors suspect this, other scans may be needed ...
Blood clots can form in the superficial veins of the legs as thrombophlebitis, causing redness or tenderness of the skin and the layers of tissue just below the skin. These types of blood clots are less of a risk and do not travel to the lungs. Diagnosis of Blood Clot Disorders During Pregnancy
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Jun 7, 2023 · Summary. Pregnancy increases the risk of deep vein thrombosis (DVT), which can result in complications that affect the pregnant person and the fetus. Managing DVT or reducing blood clot risks is ...
