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Minerva Medica 2013 October;104(5):563-78


language: Italian

Venous thromboembolism in pregnancy: current state of the art

Ralli E. 1, Zezza L. 2, Lillo R. 3, Conti E. 2, Comito C. 3, Caserta D. 1, Moscarini M. 1

1 Dipartimento di Scienze Ginecologico-Ostetriche e Scienze Urologiche, Università La Sapienza, Roma, Italia; 2 Unità di Cardiologia, Dipartimento di Medicina Clinica e Molecolare, Ospedale Sant’ Andrea Università La Sapienza, Roma, Italia; 3 Dipartimento di Chirurgia Cardiovascolare Ospedale Sant’ Andrea, Università La Sapienza Roma, Italia


Venous thromboembolism (VTE) is a major cause of maternal morbidity and mortality during pregnancy or early after delivery and it remains a diagnostic and therapeutic challenge. The latest Confidential Enquiry into Maternal Deaths (2006-2008) showed that VTE is now the third leading cause of direct maternal mortality, beside sepsis and hypertension. In particular the prevalence of VTE has been estimated to be 1 per 1000-2000 pregnancies. The risk of VTE is five times higher in a pregnant woman than in non-pregnant woman of similar age and postpartum VTE is more common than antepartum VTE. A literature search was carried out on Pubmed using the following key words: “venous thromboembolism”, “pregnancy”, “risk factors”, “prophylaxis”, “anticoagulants”. Studies from 1999 onwards were analyzed. This review aimed to provide an update of whole current literature on VTE in pregnancy highlighting the most recent findings in diagnostic and therapeutic strategies, considering in detail risks and benefits of various techniques and drug classes, for both mother and fetus. Large trials of anticoagulants administration in pregnancy are lacking and recommendations are mainly based on case series and on expert opinions. Nonetheless, anticoagulants are believed to improve the outcome of pregnancy for women with current or previous VTE.

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