Use of inferior vena cava filters in thromboembolic disease during labor: Case report with a literature review

Jamjute, Pradumna; Reed, Nick; Hinwood, David

doi:10.1080/14767050600631443

Cited by 20 publications

(11 citation statements)

References 6 publications

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“…Although the use of pneumatic compression devices for the prevention of pregnancy-related thrombosis has not been studied, extrapolating from perioperative data (76), pneumatic compression devices should be in place while anticoagulation is held, and other measures may be necessary in selected patients. Women who have had a recent venous thromboembolic event may benefit from vena caval filter placement (77)(78)(79), and women with antithrombin deficiency may benefit from antithrombin concentrates.…”

Section: Management At the Time Of Delivery And Postpartummentioning

confidence: 98%

Pregnancy and thrombotic risk

James

2010

Critical Care Medicine

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Pregnancy increases the risk of thrombosis three-fold to four-fold. The main reason for the increased risk is hypercoagulability, which has likely evolved to protect women against the bleeding challenges associated with miscarriage and childbirth. The hypercoagulability of pregnancy is present as early as the first trimester and so is the increased risk of thrombosis. Factors that further increase the risk of thromboembolism in pregnancy include a history of thrombosis, inherited and acquired thrombophilia, certain medical conditions, and complications of pregnancy and childbirth. Candidates for anticoagulation are women with a current thrombosis, a history of thrombosis, thrombophilia, and a history of poor pregnancy outcome, or risk factors for postpartum thrombosis. For fetal reasons, the preferred agents for anticoagulation in pregnancy are heparins. There are no large trials of anticoagulation in pregnancy and recommendations are based on case series and the opinion of experts. Nonetheless, anticoagulation is believed to improve the outcome of pregnancy for women at risk.

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Section: Management At the Time Of Delivery And Postpartummentioning

confidence: 98%

Pregnancy and thrombotic risk

James

2010

Critical Care Medicine

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“…62 However, it must be noted that complications with IVC filter insertion and retrieval can occur in pregnancy. 63 An attempt is usually made to place the filter in the infrarenal vena cava. However, the infrarenal vena cava may be distorted by the gravid uterus, reducing the chances of successful placement.…”

Section: Peripartum Periodmentioning

confidence: 99%

Evidence Base for the Management of Venous Thromboembolism in Pregnancy

Rodger

2010

Hematology

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Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is a leading cause of maternal mortality during pregnancy. DVT and PE are commonly suspected due to many mimicking signs and symptoms that are normal in pregnancy. However, validated diagnostic approaches are lacking, and a fear of teratogenic/oncogenic exposure from imaging procedures affects the acceptability of diagnostic approaches used for VTE during pregnancy. DVT and PE treatment in pregnancy is also challenging due to this lack of validated diagnostic approaches, changes in maternal physiology, and the need for intact hemostasis at the time of delivery/epidural analgesia. Prevention requires an optimal balancing of absolute increased bleeding risk from pharmacologic thromboprophylaxis and the absolute benefit of reduced DVT and PE, which, while serious, are relatively uncommon.

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“…Nowadays a new generation of filters allows either permanent placement or its removal, when possible, once the thromboembolic risk disappears. This last type of filters has been proposed as more secure in pregnant women with high risk of PE during peripartum period; its placement during pregnancy and subsequent removal were demonstrated to be safe in small retrospective studies [10, 13–15]. In our case, attending to the irreversible risk factors (protein C deficit, heterozygosity for both factor V Leiden and Prothrombin G20210A and positive lupus anticoagulant) presented in our patient, we chose a permanent filter.…”

Section: Discussionmentioning

confidence: 97%

Inferior Vena Cava Filter Placement during Pregnancy: An Adjuvant Option When Medical Therapy Fails

Valadares

Serrano

Torres

et al. 2013

Case Reports in Obstetrics and Gynecology

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The authors present a case of a 27-year-old multiparous woman, with multiple thrombophilia, whose pregnancy was complicated with deep venous thrombosis requiring placement of a vena cava filter. At 15th week of gestation, following an acute deep venous thrombosis of the right inferior limb, anticoagulant therapy with low-molecular-weight heparin (LMWH) was instituted without improvement in her clinical status. Subsequently, at 18 weeks of pregnancy, LMWH was switched to warfarin. At 30th week of gestation, the maintenance of high thrombotic risk was the premise for placement of an inferior vena cava filter for prophylaxis of pulmonary embolism during childbirth and postpartum. There were no complications and a vaginal delivery was accomplished at 37 weeks of gestation. Venal placement of inferior vena cava filters is an attractive option as prophylaxis for pulmonary embolism during pregnancy.

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Use of inferior vena cava filters in thromboembolic disease during labor: Case report with a literature review

Cited by 20 publications

References 6 publications

Pregnancy and thrombotic risk

Pregnancy and thrombotic risk

Evidence Base for the Management of Venous Thromboembolism in Pregnancy

Inferior Vena Cava Filter Placement during Pregnancy: An Adjuvant Option When Medical Therapy Fails

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