Pregnancy-related thromboembolism and contributing risk factors: From 10 years of experience at a Japanese tertiary obstetrics institute

Abstract

To determine the association between pregnancy-related thromboembolism and pre-existing risk factors, as well as the association between its severity and risk factors, among Japanese women. Methods: We retrospectively analyzed cases of pregnancy-related thromboembolism over 10 years at a single Japanese tertiary obstetrics institute. Patients were divided into two groups based on thromboembolism severity. Results: Our 22 thromboembolic patients had an incidence /detection rate of 0.18% (22/12,500). Deep venous thrombosis (DVT), PE, and DVT + PE occurred in 15 (68%), 3 (14%), and 4 (18%) patients, respectively. Of the 22 patients, 20 (91%) had pre-existing risk factors. Thrombophilia and bed rest were the most common, with each at 8/22 (36%). Of the 8 with thrombophilia, anti-phospholipid antibody syndrome (APS) and protein S (PS) deficiency accounted for 5 and 3 patients, respectively. Thrombophilia was detected in 7/15 (47%) and 1/7 (13%) in the severe and mild groups, respectively, showing that thrombophilia was more likely to accompany severe thromboembolism. All APS patients suffered severe thromboembolism. Conclusions: Thrombophilia and bed rest were the most common risk factors for thromboembolism in a Japanese tertiary perinatal center. The most important thrombophilic factors accompanying thromboembolism were APS and PS deficiency. Patients with thrombophilia were likely to show severe thromboembolism.