EXPERIENCE WITH GREENFIELD FILTERS IN PREGNANT-WOMEN FOR DEEP VENOUS THROMBOSIS AND PULMONARY-EMBOLISM - CASE-REPORTS

The indications for inferior vena caval filter placement in the gravid female are ill defined. During pregnancy, however, pulmonary embolism (PE) secondary to venous thrombosis is the most common cause of mater nal mortality. Pregnant women are at risk for deep venous thrombosis ( DVT) due to hypercoagulability caused by increased levels of coagulati on factors and decreased fibrinolytic activity. In addition, decreased venous tone and velocity of blood flow in the lower extremities lead to venous stasis. Although heparin is the treatment of choice for DVT associated with pregnancy, propagation of thrombus or development of b leeding diathesis mandates discontinuation of anticoagulant therapy an d consideration for caval interruption. In this review, two patients a re presented who required vena caval filters during pregnancy, and ind ications for their usage in this patient population are defined. Filte r placement is recommended during pregnancy in the presence of extensi ve iliofemoral thrombus, free-floating thrombus, bleeding complication s, or pulmonary embolism despite adequate anticoagulation.