Presentation of venous thromboembolism during pregnancy,

Objective: We sought to characterize the presentation, recurrence, and outcome of venous thromboembolism during pregnancy. Study Design: We performed a 12-year, single-center, retrospective review of 38 patients with venous thromboembolism during pregnancy. The independent variables were subjected to univariate analysis (unpaired t test for normally distributed continuous variables and Fisher exact test for discrete variables). P< .05 was considered significant. Results: There was no significant difference for the following variables according to time of presentation (antepartum vs post partum): gestational age at delivery (37.4 ± 6.6 wk vs 38.1 ± 2.4 wk; P = .7), birth weight (3257 ± 458 g vs 3093 ± 719 g; P = .3), and mode of delivery (2 vs 4 cesarean deliveries; P = .15). There were 2 maternal deaths. All 3 women with antepartum recurrent venous thromboembolism (despite heparin prophylaxis) had findings of protein C deficiency, protein S deficiency, and lupus anticoagulant–anticardiolipin antibody, respectively. Conclusion: The gestational age at presentation appears more equally distributed throughout gestation than previously reported. Notwithstanding limited numbers, the recurrence of venous thromboembolism despite use of prophylactic heparin therapy suggests the need to reexamine the current recommendations for heparin dosing. (Am J Obstet Gynecol 1999;181:1118-21.)