Thromboembolic disease in pregnancy

Thromboembolic disease (TED) is the greatest single cause of maternal death in developed countries [1,2]. In the UK, the latest report of the Confiden tial Enquiry into Maternal Deaths (Department of Health, 1998) [3], coverin g the years 1994-1996, found that there were 46 deaths from this cause, an increase from 35 in the previous report [4]. Some of this increase can be a ttributed to a better ascertainment of cases, but it is clear that death fr om TED is not declining and remains a serious concern, despite clinicians' efforts to provide thromboprophylaxis to women at risk. The majority of thr omboembolic events in pregnancy are not fatal, but in those cases TED may b e responsible for considerable long-term morbidity. There is evidence that thromboembolic events during pregnancy produce more severe and long-lasting subsequent morbidity than events outside pregnancy [5,6]. Despite the widely recognized importance of TED in pregnancy as a cause of maternal mortality and morbidity, much remains to be discovered about its e pidemiology and causes, and the effectiveness of thromboprophylaxis. Many r eviews of TED in pregnancy and thromboprophylaxis have been published in re cent years [7,8.,9.], but there is an urgent need for further research in m any areas. Research priorities are discussed in a later section.