Pregnant Women With Life-Threatening Blood Clots Should Receive Aggressive Treatment


January 23, 2012

January 23, 2012 — Pregnant women who develop dangerous blood clots in the leg often forgo the most effective treatment for fear of harming the baby. Yet treatment to remove the clot is not only safe, it can prevent serious problems, including death, suggests research being presented at the 24th International Symposium on Endovascular Therapy (ISET).

Deep vein thrombosis (DVT) – a blood clot that forms deep in the thigh – is four to six times more common in pregnant women than those who are not pregnant. A smaller blood clot can break off and travel to the lung artery causing a pulmonary embolism. When DVT is not treated early and effectively, the clot can become permanent, causing lifelong pain and blood flow problems. The most effective treatments include the minimally invasive delivery of clot-dissolving drugs directly to the clots to break them up, or surgery.

The study included 11 pregnant women with DVT. Nine were treated with minimally invasive techniques by guiding a tiny tube called a catheter to the site of the clot to deliver a bath of clot-dissolving drugs, and two had surgery to remove the clot. Treatment successfully broke up the clot in all cases. All but one of the pregnancies resulted in a successful birth. One woman in her second trimester miscarried a week after treatment. The woman suffers from antiphospholipid antibody syndrome, which causes the blood to clot abnormally and increases the risk of miscarriage, so the condition likely was the cause of her miscarriage in this case as well, researchers said. Three of the women had successful subsequent pregnancies.

Pregnant women who develop DVT are typically treated less aggressively with blood thinners, which rarely clear the clot.

“Pulmonary embolism is the second most frequent cause of death in pregnant women in North America and the United Kingdom,” said Anthony Comerota, M.D., director of the Jobst Vascular Center at The Toledo Hospital, Ohio. “Physicians should use more effective treatment to prevent these women from having serious life-long problems that can affect their ability to care for their children.”

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