Deep Vein Thrombosis in Pregnancy
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DVT (deep vein thrombosis) is a blood clot in a vein, usually the leg. DVT can be dangerous. You should get medical help as soon as possible if you think you have DVT.
Symptoms of Deep Vein Thrombosis Are:
- throbbing or cramping pain in 1 leg (rarely both legs), usually in the calf or thigh
- swelling in 1 leg (rarely both legs)
- warm skin around the painful area
- red or darkened skin around the painful area
- swollen veins that are hard or sore when you touch them
These symptoms also happen in your arm or tummy if that’s where the blood clot is. If you have one or more of these symptoms, you should call your local emergency line or go to the nearest healthcare institution as soon as possible.
What DVT in a leg can look like
In the following picture, you see a red and swollen right leg caused by deep vein thrombosis.
Call your local emergency line or go to the nearest healthcare institution if you have symptoms of deep vein thrombosis, such as pain and swelling and:
have sudden difficulty breathing
have pain or tightness in your chest or upper back
are coughing blood
Deep vein thrombosis can be very serious because blood clots in your veins can break loose, travel through your bloodstream, and get stuck in your lungs. This is called a pulmonary embolism. A pulmonary embolism can be life-threatening and needs treatment straight away.
Who is more likely to get Deep Vein Thrombosis
A DVT is more likely to happen if you:
- are over 60
- are overweight
- have had DVT before
- take the contraceptive pill or HRT
- have cancer or heart failure
- have varicose veins
There are also some temporary situations when you’re at more risk of DVT. These include if you:
- are staying in or recently left the hospital – especially if you cannot move around much (like after an operation)
- are confined to bed
- go on a long journey (more than 3 hours) by plane, car or train
- are pregnant or if you’ve had a baby in the previous 6 weeks
- are dehydrated
Sometimes DVT can happen for no obvious reason. This is called idiopathic venous thromboembolism.
How DVT is diagnosed
If a doctor thinks you have DVT, you should be referred to the hospital within 24 hours for an ultrasound scan. The scan shows whether blood is flowing normally through the vein.
You may also have an X-ray of the vein which is called a venogram. For this, you will be injected with a dye to show where the blood clot is.
Treatment of DVT
You may have an injection of an anticoagulant (blood-thinning) medicine called heparin while you’re waiting for an ultrasound scan to tell if you have a DVT. (Note: You should never use blood-thinning medications without consulting your physician)
After DVT is diagnosed, the main treatment is tablets of an anticoagulant medicine, such as warfarin and rivaroxaban. You will probably take the tablets for at least 3 months.
If anticoagulant medicines are not suitable, you may have a filter put into a large vein – the vena cava – in your tummy. The filter traps and stops a blood clot from traveling to your heart and lungs.
A newer treatment involves breaking up and sucking out the clot through a small tube in the vein. You usually need to take anticoagulant medicine for several months after this treatment.
DVT in pregnancy is treated differently. It is treated with anticoagulant injections for the rest of the pregnancy and until the baby is 6 weeks old.
Recovery from DVT
Some lifestyle measures will help you recover from DVT. After you leave the hospital, you will be encouraged to:
- walk regularly
- keep your affected leg raised when you’re sitting
- delay any flights or long journeys until at least 2 weeks after you start anticoagulant medicine
Tips to prevent DVT
In order to prevent DVT you should;
- stay a healthy weight
- stay active – taking regular walks can help
- drink plenty of fluids to avoid dehydration – DVT is more likely if you’re dehydrated
And you should not;
- do not sit still for long periods of time – get up and move around every hour or so
- do not cross your legs while you’re sitting, it can restrict blood flow
- do not smoke
- do not drink lots of alcohol
Going on a long journey
Traveling for longer than 4 hours (long-haul travel) increases your risk of developing DVT.
It’s not known if this risk is greater during pregnancy, but to reduce the risk of DVT while you’re traveling:
- drink plenty of water
- avoid drinking alcohol during pregnancy
- perform simple leg exercises, such as regularly flexing your ankles – if you’re on a flight, most airlines provide information about exercises you can do to during the flight
- if possible, walk about during refueling stops or walk up and down the bus, train, or plane (when it’s safe to do so)
Going into hospital
If you go into hospital, your healthcare team should check your risks of DVT.
If they think you’re more likely to get DVT, you may be given treatment to prevent it, such as medicine or compression stockings (knee-high elastic socks that help your blood circulation), while you’re in the hospital.
You may continue treatment after you leave the hospital because a blood clot can happen weeks later.
Deep vein thrombosis in pregnancy
DVT is not common in pregnancy. But you’re more likely to develop DVT at any stage of your pregnancy and up to 6 weeks after the birth than people of the same age who are not pregnant.
DVT does not always have symptoms. During pregnancy, it’s common to have swelling or discomfort in your legs, so this on its own does not always mean there’s a serious problem.
Are you at risk?
Your risk of developing DVT during pregnancy is even greater if you:
- or a close family member has had a blood clot before
- are over 35
- are obese (have a body mass index of 30 or more)
- have had a severe infection or recent serious injury, such as a broken leg
- have a condition that makes clots more likely (thrombophilia)
- are carrying twins or multiple babies
- have had fertility treatment
- are having a cesarean section
- have severe varicose veins (ones that are painful or above the knee with redness or swelling)
- are dehydrated
Managing DVT in pregnancy
If you develop a DVT while pregnant, you’ll probably need injections of medicine to stop the blood clot from getting bigger so your body can dissolve it. The medicine, called heparin, does not affect your developing baby.
The injections also reduce your risk of getting a PE and developing another clot.
You’ll usually need to have the injections for the rest of your pregnancy and until at least 6 weeks after the birth of your baby.
Although medical treatment for DVT is essential, there are also things you can do to help yourself.
- staying as active as you can – your midwife or doctor can advise you on this
- wearing prescribed compression stockings to help the circulation in your legs