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Williams Obstetrics, 23e
| Section VII. Obstetrical Complications > |
Chapter 47. Thromboembolic Disorders
Sections: Thromboembolic Disorders: Introduction, Pathophysiology, Thrombophilias, Deep-Venous Thrombosis, Superficial Venous Thrombophlebitis, Pulmonary Embolism, Thromboprophylaxis, References.
Topics Discussed: thromboembolism.
Excerpt:"The risk of venous thrombosis and pulmonary embolism in otherwise healthy women is considered highest during pregnancy and the puerperium. Indeed, the risk of pulmonary embolism has been estimated to be as much as four- to sixfold higher during pregnancy (Christiansen and Collins, 2006; Marik and Plante, 2008). The incidence of all thromboembolic events averages about 1 per 1000 pregnancies, and about an equal number are identified antepartum and in the puerperium. In a recent study from Norway of more than 600,000 pregnancies, Jacobsen and colleagues (2008) reported that deep-venous thrombosis alone was more common antepartum whereas pulmonary embolism was more common in the first 6 weeks postpartum. The frequency of venous thromboembolic disease during the puerperium has decreased remarkably as early ambulation has become more widely practiced. Even so, there is evidence that it has increased 50 percent from 1999 to 2005 (Kuklina and associates, 2009). Importantly, pulmonary embolism still remains a leading cause of maternal death in the United States (see Table 1-2). By way of example, pulmonary embolism caused approximately 9 percent of the 623 pregnancy-related deaths in the United States in 2005 (Kung and co-workers, 2008)...."
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