Pregnancy and childbirth are exciting times in most women’s lives. Although pregnancies and childbirth result in miraculous new life, they also put the pregnant or postpartum woman at a higher risk of contracting several conditions, one of which is Deep Vein Thrombosis or DVT.
What is DVT?
Deep vein thrombosis, or DVT, is a condition where a blood clot forms in your body, usually in the lower leg, thigh, or pelvic veins. Up to 90% of all DVT incidences during pregnancy occur in the left leg. Although most women with DVT during pregnancy go on to have completely healthy babies, if the DVT is not treated in time, it can transform into a life-threatening condition called Pulmonary Embolism (PE). This is why it is essential to seek DVT treatment immediately if you are at risk or have been diagnosed with it.
A pulmonary embolism or PE is a condition where the blood clot breaks off into the bloodstream and makes its way to the lungs, where it may block a blood vessel and oxygen transfer in the lungs. This complication needs immediate, emergency treatment.
Although DVT is not very common in pregnancy, being pregnant or recently having given birth raises your chances of getting a blood clot up to five times compared to people of the same age who are not pregnant. This risk increases up to 20 times in the six weeks after birth!
Causes of DVT in Pregnancy:
Pregnant women are at a higher risk of DVT for several reasons. Some of these are:
During pregnancy and after childbirth, a woman’s blood clots faster to prevent excessive blood loss during delivery.
Due to the extra weight around the pelvis, blood vessels may be pressed, preventing easy blood flow to the legs.
Pregnant women may also be less active, another risk factor for DVT.
Estrogen levels rise during pregnancy, which can increase the possibility of blood clots.
Risk factors for DVT in Pregnancy:
Women who are at higher risk for contracting DVT during pregnancy include those who:
Have a family or personal history of DVT or PE
Are overweight or obese
Have delivered via caesarean section
Smoke
Have preeclampsia, or other chronic health diseases like hypertension, diabetes
Are on strict bed rest orders
Are over the age of 35
Are carrying multiples
Have severe varicose veins.
Symptoms of DVT:
Often, it can be challenging to differentiate the symptoms of DVT from those of muscle cramps. Muscle cramps are incredibly common during pregnancy - muscle cramps, swelling and heaviness in the legs alone do not mean a woman has DVT. Moreover, DVT doesn’t always show symptoms. However, some common symptoms which may appear in DVT include:
Swelling in the affected area
Hot, red or discoloured skin
Pain or tenderness in the affected area.
If you experience these symptoms, you must get in touch with your GP, midwife or obstetrician immediately, who may then refer you to a vascular surgeon like Dr Adrian Ling.
However, if you experience the following symptoms, call 000 or head to the emergency department of your nearest hospital immediately. These could be signs of a pulmonary embolism (PE):
Pain in the chest or upper back that worsens with a cough or deep breath
Coughing up blood
Difficulty breathing
Irregular or abnormally fast heart rate.
Diagnosing DVT
Very rarely is DVT diagnosed based on symptoms alone. If your doctor, midwife or obstetrician suspects DVT, you will be recommended a blood test called a D-dimer test which detects blood clots in the bloodstream. You may also be advised to have an ultrasound to confirm the presence of a blood clot, after which you may be referred to a hematologist or vascular surgeon for treatment.
Treating DVT
There are several different DVT treatment options. Depending on your condition's severity and any pre-existing health conditions, Dr Adrian Ling may suggest various treatment methods. Some of these include:
Using blood thinning medication. This medication prevents the blood clot from getting bigger and prevents any new clots from forming. It also helps the body to break down the clot.
A minimally invasive treatment that involves using a ‘clot-busting’ medication that is sprayed directly into the clot with a catheter. This clot is then sucked out like a vacuum from the vein. However, this treatment is usually referred only to those with severe cases of DVT.
Preventing DVT in pregnancy:
You can take a few steps to lower your risk of DVT during pregnancy. These include:
Staying active. Being overweight and sedentary may prevent your blood from flowing easily. However, if you’ve been advised to be on bed rest due to a complicated pregnancy, your doctor may recommend blood thinners (especially if you’re already at risk of DVT).
Getting up and moving around when travelling. Especially on long-haul flights or bus or car rides, try to get up every few hours, walk around, and do ankle exercises while you sit.
Staying hydrated. Pregnant women should drink at least ten glasses of liquid every day, increasing this to 12 to 13 glasses while breastfeeding.
Wearing compression stockings. These help improve circulation in the feet and reduce swelling, making them an excellent way to prevent DVT.
Dr Adrian Ling is a highly-qualified vascular and endovascular surgeon with extensive experience treating DVT and related conditions. If you suspect that you have DVT or have been diagnosed with it, or are looking for spider veins or varicose veins treatment, get your GP to write you a referral to Dr Ling to learn more about your treatment options.
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