Management of deep vein thrombosis and pulmonary embolism (venous thromboembolism) during pregnancy.

PURPOSE: The risk of venous thromboembolism (VTE) is high during pregnancy. Although most patients with VTE are safely treated via medications, the optimal treatment for massive pulmonary embolism remains controversial. To evaluate the safety and efficacy of VTE management during pregnancy, we report our single center experience of treating VTE in pregnant women.

METHODS: Case records were retrospectively reviewed from seven patients who underwent treatment for venous thromboembolism between 2002 and 2014.

RESULTS: Mean gestational time was 28 ± 6.2 weeks. Four patients with deep vein thrombosis were treated medically, and they all had vaginal delivery at full term without hemorrhagic complication. Three patients with massive pulmonary embolism underwent surgical embolectomy. Two of these three patients underwent cesarean delivery at 28 and 29 weeks respectively. There was no maternal death, but one fetal death occurred during surgical embolectomy.

CONCLUSION: VTE during pregnant women is safely managed by anticoagulant therapy. Massive pulmonary embolism during pregnancy can be managed safely by surgical embolectomy using cardiopulmonary bypass, but the rate of fetal loss remains high.