Journal of the Korean Medical Association, Vol.59(1) : 8-13, 2016
Pregnancy-related venous thromboembolism (VTE) is one of the leading causes of maternal morbidity and mortality,
developed in the antenatal and postpartum periods of pregnancy. The incidence of VTE during normal pregnancy
is four- to six-fold higher than in the general reproductive aged female population. Physiologic changes such as
hypercoagulable state, decreased venous capacitance, and reduced venous blood flow due to mechanical obstruction
from gravid uterus compromise this condition. The prominent risk factors for VTE are thrombophilia, history of
circulatory disease and previous VTE, preeclampsia and related disorders, and Cesarean section. In case of suspicion
of VTE, prompt diagnosis and management are needed with the caution of potential adverse effects on the fetus.
Low molecular weight heparin treatment is preferred due to better safety, more consistent bioavailability, ease of
administration, lower risk of drug-related osteoporosis and thrombocytopenia and easier monitoring. For pregnant
women with acute VTE, adjusted-dose subcutaneous low molecular weight heparin should be administrated
antenatally and continued for at least 6 weeks postpartum. For prevention of VTE, mechanical prophylaxis such
as physiotherapy, exercise, compression stockings, and intermittent pneumatic compression devices could be used.
Thromboprophylaxis should also be considered for pregnant subjects with certain risks such as carriers of molecular
thrombophilia or previously experienced VTE.