RESUMEN
Background: Venous thromboembolism (VTE), manifesting as pulmonary embolism (PE) or deep vein thrombosis (DVT), is the most common cause of morbidity and death during pregnancy and the postpartum period. We conducted this study to describe the predictors of pregnancy-associated VTE (DVT and PE). Methods: A case-control study was conducted at a tertiary care center in Riyadh. A total of 380 patients were included in this study, 180 of whom were diagnosed with pregnancy-associated thrombosis and 200 of them showed no VTE. Demographic data and data on risk factors of VTE were collected by reviewing the medical charts and the risk assessment tool of the Royal College of Obstetricians and Gynecologists, respectively. The main outcome measures were VTE, manifesting as PE or DVT. Results: The following factors were identified as the predictors of VTE through multivariate analysis: family history [Odds ratio (OR) = 50.47, 95% Confidence Interval (CI): 6.78-375.64, P < 0.0001)], thrombophilia (OR = 21.99, 95% CI: 2.83-170.63, P = 0.003), and presence of gross varicose veins (OR = 17.15, 95% CI: 3.93-74.87, P < 0.0001). Conclusions: The findings of this study showed that family history, thrombophilia, and the presence of gross varicose veins were risk factors for VTE, exceeding other transient risk factors. Hence, prophylaxis is highly recommended for those women who present with any of these factors.
RESUMEN
BACKGROUND: Pregnancy is one of the major risk factors for the development of venous thromboembolism (VTE). OBJECTIVE: To elucidate the circumstances surrounding pregnancy-induced deep vein thrombosis (DVT) and pulmonary embolism (PE), assess potential factors triggering thrombosis (e.g., thrombophilia, obesity, age, parity, and family history), initial and long-term management, and assess recurrence rate and mortality for VTE in pregnant Saudi women. METHODS: A retrospective chart review of 180 patients with objectively confirmed VTE (DVT, PE, or both) that occurred during pregnancy, or the postpartum period was conducted. All patients who experienced episodes of objectively confirmed VTE were included. RESULTS: Overall, 180 patients were included. Further, 60% (n = 109) and 40% (n = 71) of the VTE cases occurred during the postpartum and antenatal periods, respectively. Cesarean section was the most prevalent risk factor among study participants (n = 86 (47.8%)), followed by obesity (n = 73 (40.6%)). The most common clinical presentations were lower leg pain (57.2%) and lower limb swelling (54.4%). VTE recurrences were observed in approximately 11% of the participants, and maternal mortality occurred in 2 (1.1%) cases. CONCLUSION: Pregnancy was the most common provoking factor for VTE in our study. Pregnant women should undergo formal, written assessments of risk factors for VTE at the first visit and delivery. Larger studies with a randomized design, and control groups are required to confirm the current findings.