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A study of more than 200,000 women came to the result that admission to inpatient care during pregnancy was associated with an 18-fold increase in the risk of venous thromboembolism (VTE) during the stay, and a 6-fold increase in risk in the four weeks after discharge, compared with pregnant women who did not require hospitalization. [5]
The Royal College of Obstetricians and Gynaecologists (RCOG) is a professional association based in London, United Kingdom. Its members, including people with and without medical degrees, work in the field of obstetrics and gynaecology , [ 1 ] that is, pregnancy , childbirth , and female sexual and reproductive health .
The mainstay of VTE management is anticoagulation therapy, which prevents thrombus propagation and embolization. Such treatment reduces the risk of recurrence. [5] [4] [1] The choice and duration of anticoagulation depend on the individual patient's risk factors, bleeding risk, and preferences.
Numerous medications have been shown to reduce the risk of a person having a VTE, however careful decision making is required in order to decide if a person's risk of having a VTE outweighs the risks associated with most thromboprophylaxis treatment approaches (medications to prevent venous thrombosis).
As such, family history of VTE is a risk factor for a first VTE. [88] Factor V Leiden, which makes factor V resistant to inactivation by activated protein C, [88] mildly increases VTE risk by about three times. [14] [88] Deficiencies of three proteins that normally prevent blood from clotting—protein C, protein S, and antithrombin ...
There has been some success in preventing blood clots by an early risk assessment upon admission to the hospital, which is a strategy recognized by the Centers for Disease Control and Prevention. Hospitals that have participated in this effort to reduce the incidence of thrombosis found that rates of DVT decreased in some instances. [ 34 ]
VTE has a large, and continuously rising, case fatality rate. [27] This rate is roughly 10% after 30 days, 15% after three months, and up to 20% after one year. [27] Pulmonary embolisms alone (when resulting in hospitalizations) have a case fatality rate of about 5% to 10% so VTE can play a large factor in the severity of the embolisms. [27]
Non-modifiable risk factors include a family history of diabetes, advanced maternal age, and ethnicity. Modifiable risk factors include maternal obesity. [14] There is an elevated demand for insulin during pregnancy which leads to increased insulin production from pancreatic beta cells. The elevated demand is a result of increased maternal ...