Coagulation changes in pregnancy

Advanced, Anatomy, Clinical Subspecialties, Obstetric Anesthesia

The risk of developing a venous thromboembolism increases about 100-fold when a parturient is admitted to a hospital and also seems to be worse during the third trimester. This is thought to be due to changing hormonal levels, in particular increased estrogen as pregnancy progresses.  It is important to note that the classic Virchow’s Triad favors thrombus formation in pregnancy with increased venous stasis, increased coagulability factors, and increased endothelial damage.  Risk of venous thromboembolism in pregnancy increases with the following additional risk factors:  obesity, smoking, multiple gestations, advanced maternal age, increased parity, cesarean section, as well as the presence of a concomitant thrombophila.  Unfractionated heparin and low molecular weight heparin are the modalities of choice for anticoagulation during pregnancy.

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2020

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