Vascular Health and Risk Management (Jul 2023)
Venous Thromboembolism in Pregnancy: Challenges and Solutions
Abstract
Dimitrios Varrias,1,2,* Michail Spanos,3,* Damianos G Kokkinidis,4 Panagiotis Zoumpourlis,1,2 Dimitrios Rafail Kalaitzopoulos5 1Department of Medicine, Jacobi Medical Center, Bronx, NY, 10461, USA; 2Albert Einstein College of Medicine, Bronx, NY, 10461, USA; 3Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, USA; 4Section of Cardiovascular Medicine, Yale University School of Medicine, Yale New Haven Hospital, New Haven, CT, USA; 5Department of Gynecology and Obstetrics, Cantonal Hospital Schaffhausen, Schaffhausen, Switzerland*These authors contributed equally to this workCorrespondence: Dimitrios Varrias, Jacobi NYCHHC, 1400 Pelham Parkway South, 3N1, Bronx, NY, 10461, USA, Tel +1 7189185000, Email [email protected]: Venous thromboembolism (VTE) is a serious medical condition that can lead to severe morbidity and mortality, making it a significant public health concern. VTE is a multifactorial condition that results from the interaction of genetic, acquired, and environmental factors. Physiological changes during pregnancy increase the risk of VTE as they express Virchow’s triad (increased coagulation factors, decreased fibrinolysis, trauma, and venous stasis). Moreover, pregnancy-related risk factors, such as advanced maternal age, obesity, multiple gestations, and cesarean delivery, further increase the risk of VTE. Managing VTE in pregnancy is challenging due to the complexity of balancing the risks and benefits of anticoagulant therapy for both the mother and the fetus. A multidisciplinary approach involving obstetricians, hematologists, and neonatologists, is necessary to ensure optimal outcomes for both the mother and baby. This review aims to discuss the current challenges associated with VTE in pregnancy and identify potential solutions for improving outcomes for pregnant women at risk for VTE.Keywords: venous embolism, thrombosis, pregnancy, VTE, anticoagulation
