Bushra Mehmood, Muhammad Abid, Shakeela Khanum, Asad Kamran.
Deep Vein Thrombosis during Pregnancy Workup.
Pak J Med Health Sci Jan ;12(3):1214-7.

Background: During pregnancy deep vein thrombosis (DVT) is a considerable factor which contributed to increase maternal fatal mortality and morbidity. It may transpire when there is thrombophilia, because of compression of inferior vena cava (IVC ), hormonal changes or venous stasis. Aim : To assess patients who were pregnantor just given birth and with the condition of deep vein thrombosis in lower limbs. Method : The study was conducted at Department of Gynaecology and Obstetrics, Lodhran during from August 2016 to May 2018 , pregnant were assessed and puerperal patients when there was doubt of deep vein thrombosis. During study period there were 4000 childbirths at hospital in which cesarean were 89%, normal births were 7.5% and forceps deliveries were 3.5%. Eighty four cases were clinically diagnosed as DVT, out of total referred patients with clinical status suggesting deep vein thrombosis, confirmed through venous duplex scan. The age group of pregnant females was 21-years to 39-years. Results: Out of 84 DVT patients, primigravida were 64 (with no thrombophilia changes there were six twin pregnancies, four resulting from in vitro fertilization ), 16 were second birth mothers and at third birth were 4. DVT was occurred in pregnancy first trimester in 8 patients (9.52%), in second trimester DVT was present in 22 patients (26.19%) and in third trimester of pregnancy DVT was developed in 54 (6 4.29%) patients. Of the 84 DVT diagnosed patients, 36 ( 42.85%) occurred in infrapatellar veins. In a thirty seven year old patient, there was a case of pulmonary thromboembolism which submitted to in vitro fecundation, with twin pregnancy after C-section a diagnostic of DVT (no thrombophilia). Of the 84 patients, 32 (38.09%) had cause of their deep vein thrombosis (DVT) determined, with prevalence of heterozygous mutation of factor-V Leiden in 12 (14.28%) patients followed by phospholipid syndrome as well as other reasons. Conclusion: Despite having low frequency during pregnancy DVT is a major reason of increase maternal fetal morbidity. In selected cases thrombophilia investigation should be conducted, such as family or personal history of thrombotic phenomena and thrombophilia. Artificial insemination, twin pregnancy and cesarean births were also observed as a leading factor of DVT.

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