Management of lower extremity deep vein thrombosis in pregnancy

Learning Objectives Review the existing published guidelines regarding management of DVT in pregnancy. Discuss all treatment options including techniques, risks and benefits, and outcomes: conservative management, including anticoagulation and compression stockings; catheter-directed treatments, including lytic infusion catheters and pharmacomechanical thrombolysis (Trellis, Angiojet). Surgical thrombectomy. Understand the special considerations regarding treatment for DVT in pregnant patients: radiation effects on the fetus Medication effects on the fetus (tPA, heparin, warfarin, sedation medications); anticoagulation recommendations; mechanical compression of the gravid uterus on the iliac vein, including stents. Background Pregnancy poses a multi-factorial, two to four fold increase in risk of deep venous thrombosis (DVT). Prominent amongst these include hypercoagulability, venous stasis, immobility and mechanical compression from the gravid uterus. Effective guidelines regarding the optimal approach and treatment of DVT in pregnant patients are outdated or lacking, to the detriment of these patients. Clinical Findings/Procedure Details None Conclusion and/or Teaching Points Management of lower extremity DVT in pregnancy is an evolving topic, especially regarding newer interventional treatments, with limited data and guidelines. In order to optimally counsel and manage these patients, an understanding of all treatment options and the special considerations regarding treatment for DVT in pregnancy is required.