Deep vein thrombosis: pregnancy: occurred at any time.

Clinical bottom line (level 2c)

  1. In pregnant women, deep vein thrombosis occurred in any trimester.
  2. Most DVTs occurred in the left leg.
Ginsberg et al: Thrombosis and Haemostasis 1992; 67 (5): 519-520
Expires May 2003

The study

Outcome study with objective outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: three hospitals, Canada, Holland and Italy

60 patients (aged ?, 100% female) pregnant women with first episode of deep vein thrombosis (diagnosed by ultrasound or impedance plethysmography- confirmed by venogram in the third trimester)



Outcomes studied:
  • DVT in 1st trimester (0-91 days)
  • DVT in 2nd trimester (92 to 182 days)
  • DVT in 3rd trimester (183 days to term)

    • Patients with suspected deep vein thrombosis had ultrasound or venography. Patients with suspected pulmonary embolism had ventilation-perfusion scanning.

    The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    DVT in 1st trimester (0-91 days) ? 13/60 22%
    (11% to 32%)
    DVT in 2nd trimester (92 to 182 days) ? 28/60 47%
    (34% to 59%)
    DVT in 3rd trimester (183 days to term) ? 19/60 32%
    (20% to 43%)

    • No significant difference in incidence for any trimester.
    • All patients had DVTs in their left leg (two bilateral).

    Comments

    1. Small numbers make the results, especially in distribution of thrombosis against trimester, less certain.

    Citation

    1. Ginsberg JS, Brill-Edwards P, Burrows RF, et al: Venous thrombosis during pregnancy: leg and trimester of presentation. Thrombosis and Haemostasis 1992; 67 (5): 519-520
    Contributor: Chris Ball and Clare Wotton, May 2000
    Reviewer: Lucia Balea

    Clinical Question.
    Patient pregnant women with DVT
    Intervention or Exposure prevalence of DVT
    Outcome in each trimester