Presentation of venous thromboembolism during pregnancy

OBJECTIVE: We sought to characterize the presentation, recurrence, and outc ome of venous thromboembolism during pregnancy. STUDY DESIGN: We performed a 12-year, single-center, retrospective review o f 38 patients with venous thromboembolism during pregnancy. The independent variables were subjected to univariate analysis (unpaired t test for norma lly distributed continuous variables and Fisher exact test for discrete var iables). P < .05 was considered significant. RESULTS: There was no significant difference for the following variables ac cording to time of presentation (antepartum vs post partum): gestational ag e at delivery (37.4 +/- 6.6 wk vs 38.1 +/- 2.4 wk; P = .7), birth weight (3 257 +/- 458 g vs 3093 +/- 719 g; P = .3), and mode of delivery (2 vs 4 cesa rean deliveries; P = .15). There were 2 maternal deaths. All 3 women with a ntepartum recurrent venous thromboembolism (despite heparin prophylaxis) ha d findings of protein C deficiency, protein S deficiency, and lupus anticoa gulant-anticardiolipin antibody, respectively. CONCLUSION: The gestational age at presentation appears more equally distri buted throughout gestation than previously reported. Notwithstanding limite d numbers, the recurrence of venous thromboembolism despite use of prophyla ctic heparin therapy suggests the need to reexamine the current recommendat ions for heparin dosing.