Deep vein thrombosis in early pregnancy: A retrospective study

Objective

To investigate the clinical characteristics, management, and prognosis of deep vein thrombosis (DVT) during early pregnancy.

Methods

We conducted a retrospective study among women with DVT during their first trimester of pregnancy who were admitted to the obstetrics department of Peking University People's Hospital between March 2008 and May 2021.We analyzed clinical data of eight patients, including their general condition, obstetric characteristics, diagnosis, treatment, and gestational outcomes.

Results

Risk factors for DVT in the first trimester included personal history of DVT, thrombophilia and immune diseases, and DVT was more likely to affect the left leg. The main manifestation of DVT was pain or swelling of the affected limbs. D-dimer levels after anticoagulant treatment showed a downward trend compared with those before treatment (P ​= ​0.09), while D-dimer levels increased significantly after delivery compared with those before delivery (P ​= ​0.03). All the patients started on low-molecular-weight heparin (LMWH) therapy after a diagnosis of DVT. Temporary inferior vena cava (IVC) filters were implanted in 3 patients with mixed thrombosis before delivery, but were removed after the operation. Except for 1 case with thrombophilia who refused treatment, others underwent anticoagulation therapy from 6 weeks to 1 year postpartum. Seven patients achieved a successful delivery with live births.

Conclusion

During early pregnancy, DVT was more common in women with maternal risk factors. More cases of venous thromboembolism (VTE) were observed in the left leg. For women with a high risk of DVT, medical intervention, early identification, accurate diagnosis and precise treatment during early pregnancy should be promoted.