One of the leading causes of maternal death in the United States is blood clots (thromboembolism) that can block the flow of blood to vital organs. Pregnancy is associated with a four-fold increase in the risk of thromboembolism, which may be due to slower blood flow, compression of the pelvic and other veins, and decreased mobility. Cesarean deliveries are associated with a near doubling of the risk for thromboembolism and are an independent risk factor for thromboembolism.
Most of the blood clots experienced by pregnant women are veinous thromboembolism (VTE). Pregnant women who develop blood clots are more often found to have them in their lower extremities and often in the deep veins of the left leg, which typically cause pain and swelling in the effected extremity. If the blood clots travel to the lungs, they can cause a pulmonary embolism, which is potentially fatal and which is most often accompanied by the sudden onset of shortness of breath, chest pain, and coughing.
The American College of Obstetricians and Gynecologists (ACOG), whose 55,000 members provide health care to women, advocates for quality health care for women, and promulgates clinical practice standards for its members, recently issued new recommendations for women undergoing cesarean deliveries in an effort to reduce the incidence of thromboembolism in this population. The recommendations include the use of inflatable compression devices on pregnant women’s legs before cesarean deliveries that are then left in place until the new mothers are able to walk after their cesarean deliveries. For women who were placed on anticoagulant medication (blood thinners) during their pregnancy, the inflatable compression devices should be kept in place until the resumption of anticoagulant therapy.
ACOG also recommends that women who had an acute VTE during pregnancy, those who have a history of thrombosis, and other women who are a significant risk for developing VTE during pregnancy or after giving birth, should be given preventive treatment with anticoagulant medications, with continuing assessment.
As with any new recommendations regarding medical treatment and care, you should thoroughly discuss your treatment options and treatment plan with your health care provider to insure that you are receiving the best possible medical care for your medical condition and that you achieve the best possible outcome.
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