gynecology and obstetrics
Thromboembolic Disorders in Pregnancy
Treatment
Similar to that in nonpregnant patients, except for avoidance ofwarfarin For women with increased risk, prophylactic low molecular weightheparinthroughout pregnancy and for 6 weeks postpartum crosses the placenta and may cause fetal abnormalities or death (see table Some Drugs With Adverse Effects During Pregnancy ). Indications for thrombolysis during pregnancy are the same as for patients who are not pregnant. If PE recurs despite effective anticoagulation, surgery, usually placement of an inferior vena cava filter just distal to the renal vessels, is indicated. If women developed DVT or PE during a previous pregnancy or have an underlying thrombophilic disorder, they are treated with prophylactic LMWH (eg,enoxaparin40 mg subcutaneously once a day) beginning when pregnancy is first diagnosed and continuing until 6 weeks postpartum. 