Thromboembolic Disease and Pregnancy: Are All Women Equal?
Authors: Richard V. Lee
Journal: Annals of Internal Medicine (1996)

Editorials15 December 1996Thromboembolic Disease and Pregnancy: Are All Women Equal?Richard V. Lee, MDRichard V. Lee, MDState University of New York at Buffalo, Buffalo, NY 14222.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-12-199612150-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Pregnancy primes women to form clots [1]. Circulating levels of various clotting factors-fibrinogen and factors VII, VIII, IX, X, and XII-increase during gestation. Concentrations of some inhibitors of coagulation, such as free and total protein S, decrease during pregnancy. What is truly remarkable is the rarity, given the potential for the formation of clots, of serious thromboembolic events in pregnant women. The mechanisms whereby the blood of a healthy woman remains liquid during gestation are, for the most part, obscure.The current confusion about the clinical management of thromboembolic disease during pregnancy reflects our incomplete understanding of the molecular biology ...References1. deSwiet M. Thromboembolic disease, In: Lee RV, Garner P, Barron W, Coustan D, eds. Current Obstetric Medicine. Chicago: Mosby-Year Book; 1993:163-82. Google Scholar2. deGroot CJ, Taylor RN. The role of endothelium in pregnancy and pregnancy related diseases. In Lee RV, Garner P, Barron W, Coustan D, eds. Current Obstetric Medicine. Chicago: Mosby-Year Book; 1993:107-37. Google Scholar3. Wu KK, Thiagarajan P. Role of endothelium in thrombosis and hemostasis. Annu Rev Med. 1996; 47:315-31. Google Scholar4. Kistner RL, Eklof B, Masuda EM. Diagnosis of chronic venous disease of the lower extremities: the "CEAP" classification. Mayo Clin Proc. 1996; 71:338-45. Google Scholar5. Ginsberg JS, Brill-Edwards P, Burrows RF, Bona R, Prandoni P, Buller HR, et al. Venous thrombosis during pregnancy: leg and trimester of presentation. Thromb Haemost. 1992; 67:519-20. Google Scholar6. Treffers PE, Huidekoper BL, Weenink GH, Kloosterman GJ. Epidemiological observations of thrombo-embolic disease during pregnancy and in the puerperium, in 56,022 women. Int J Gynaecol Obstet. 1983; 21:327-31. Google Scholar7. Friederich PW, Sanson BJ, Simioni P, Zanardi S, Huisman MV, Kindt I, et al. Frequency of pregnancy-related venous thromboembolism in anticoagulant factor-deficient women: implications for prophylaxis. Ann Intern Med. 1996; 125:955-60. Google Scholar8. Barbour LA, Smith JM, Marlar RA. Heparin levels to guide thromboembolism prophylaxis during pregnancy. Am J Obstet Gynecol. 1995; 173:1869-73. Google Scholar Author, Article, and Disclosure InformationAffiliations: State University of New York at Buffalo, Buffalo, NY 14222.Corresponding Author: Richard V. Lee, MD, 7664 East Quaker Road, Orchard Park, NY 14127. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFrequency of Pregnancy-Related Venous Thromboembolism in Anticoagulant Factor-Deficient Women: Implications for Prophylaxis Philip W. Friederich , Bernd-Jan Sanson , Paolo Simioni , Sandra Zanardi , Menno V. Huisman , Iris Kindt , Paolo Prandoni , Harry R. Buller , Antonio Girolami , and Martin H. Prins Metrics Cited byPrevious thrombosis-free pregnancies are no guarantee that subsequent oral contraception may also remain asymptomaticStroke in pregnancyLUPUS PREGNANCYCerebrovascular disease in pregnancyManagement of thrombophiliaVenous Thromboembolism in PregnancyOutcome of pregnancy in three patients with primaryantiphospholipid syndrome after strokeMEDICATION USE DURING PREGNANCY FOR NEUROLOGIC CONDITIONS 15 December 1996Volume 125, Issue 12Page: 1001-1003KeywordsAnticoagulantsHeparinMedical risk factorsPregnancyProphylaxisProtein C deficiencyProtein S deficiencyResearch laboratoriesThromboembolismVenous thromboembolism ePublished: 15 August 2000 Issue Published: 15 December 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...