By Dr R Sekhar
Thrombosis, also referred to as the formation of a blood clot (thrombus) in the blood vessel, is an often undiagnosed and untreated condition with severe repercussions. There are about 15 different types of thrombosis which affect different parts of the body. The most asymptomatic among these is Deep Vein Thrombosis (DVT). To understand why DVT is so problematic, one must first understand what deep veins are.
Deep veins are those which are much farther away from the skin than other veins. When a clot is formed in one of the deep veins, if untreated, it could potentially travel through the circulatory system and get settled in other parts of the body (also known as thromboembolism). During pregnancy, levels of the blood-clotting factor fluctuate, which poses an increased risk. Nearly 80 per cent of pregnant women are at a fivefold risk of the ailment.
What causes DVT in pregnancy?
It is a little-known fact that DVT is one of the leading causes of mortality in pregnant women. Women in their third trimester of pregnancy and first week of post-partum are at a high risk. In some cases, women in their first trimester may also be at an increased risk of developing DVT. Other risk factors include history of thrombosis, abnormal tendency to develop blood clots (also known as thrombophilia – present in nearly 20-50 per cent of pregnant and postpartum women), complicated caesarian delivery and other pregnancy complications such as obesity, hypertension and heart disease. Caesarian deliveries have also been identified as an independent risk factor for the condition. Women who undergo caesarian delivery are at a fourfold risk of developing this ailment than those who opt for a normal delivery.
What can you do about it?
Based on expert opinions and consensus, pregnant women with a history of thrombosis should be tested for autoimmune disease, wherein the anti-bodies attack and damage the body’s cells and tissues, leading to formation of blood clots. Based on the diagnosis, an adjusted dose of therapeutic blood thinners is recommended to pregnant women with a history of recurrent thrombosis. In order to minimise post-delivery bleeding complications in women with a history of this condition, it is suggested that women resume the use of therapeutic blood thinners between six to 12 hours post-childbirth, in case of caesarian delivery and four to six hours, in case of normal delivery.
Deep Vein Thrombosis can be a silent killer during pregnancy. With early intervention and effective treatment, the condition is not only curable but also preventable. Effective use of therapeutics is of utmost importance. Lifestyle changes such as regular exercise and a healthy diet can help keep pregnancy-related complications such as obesity and hypertension in check. This can also help women prevent DVT in their current and future pregnancies.
(The writer is Consultant – Vascular and Endovascular Surgery, Kokilaben Hospital, Mumbai.)