Venous Thromboembolism in Pregnancy


Address correspondence to Dr Shapiro, Pulmonary/Critical Care Division, St. Luke's Hospital MU316, 1111 Amsterdam Ave., New York, NY 10025.


The risk of venous thromboembolism (VTE) is increased in pregnancy and puerperium. Thrombophilia has been identified in pregnancy-related VTE. Venous ultrasound and ventilation-perfusion lung scanning are the initial tests; pulmonary angiography should be performed if necessary for the definitive diagnosis. Anticoagulation is achieved with heparin antepartum and warfarin postpartum. Low molecular weight heparin has been effective and safe in pregnancy. Thrombolytic therapy has been administered to pregnant patients.