Superficial Vein Thrombosis: Incidence in Association with Pregnancy and Prevalence of Thrombophilic Defects

Summary

Superficial venous thrombotic (SVT) events are a feature of thrombophilic abnormalities, particularly those involving the protein C pathway. We have determined the incidence of SVT associated with pregnancy and the early postpartum period in a retrospective study involving 72 000 deliveries. Fourty-nine cases occurring in 47 individuals were recorded, with an overall incidence of 0.68/1000 deliveries (95% CI 0.48-0.88). None had a previous history of deep vein thrombosis or pulmonary embolism. Most events occurred in the early post-partum period (0.54/1000 deliveries). Twenty-four/fourty-seven were screened for established thrombophilic abnormalities, with only 1 abnormality detected (FV^Leiden heterozygote). Thrombophilia may play a minor role in the aetiology of SVT associated with pregnancy, although a larger study is required to confirm this.

• References

• 1 Hillarp A, Dahlbäck B, Zöller B. Activated protein C resistance: From Phenotype to Genotype and Clinical Practice. Blood Reviews 1995; 9: 201-12.
• 2 Greer IA. Haemostasis and thrombosis in pregnancy. In: Haemostasis and Thrombosis in Pregnancy. Bloom AL, Forbes CD, Thomas DP, Tuddenham EGD. eds Churchill Livingstone; Edinburgh: 1994: 987-1015.
• 3 McColl MD, Ramsay JE, Tait RC, Walker ID, McCall F, Conkie JA, Carty M, Greer IA. Risk factors for Pregnancy Associated Venous Thromboembolism. Thromb Haemost 1997; 78: 1183-8.
• 4 Toglia MR, Weg JG. Venous Thromboembolism During Pregnancy. N Engl J Med 1996; 335: 108-14.
• 5 The Royal College of Obstetricians and Gynaecologists: Report of the RCOG Working Party on Prophylaxis Against Thromboembolism in Gynaecology and Obstetrics. 1995
• 6 De Swiet M, Fidler J, Howell R, Letsky E. Thromboembolism in pregnancy. In: Thromboembolism in Pregnancy. Jewell D. (ed) Pitman Medical; Tunbridge Wells: 1981: 309-17.
• 7 James K, Lohr J, Deshmukh R, Cranley JJ. Venous thrombotic complications of pregnancy. Cardiovasc Surg 1996; 4: 777-82.
• 8 Macklon N, Greer I. Venous thromboembolic disease in Obstetrics and Gynaecology: The Scottish experience. Scot Med J 1996; 41: 83-6.
• 9 Rutherford S, Montoro M, McGehee W, Strong T. Thromboembolic disease associated with pregnancy: an 11 year review. Am J Obstet Gynaecol 1991; 164 (suppl) 286.
• 10 Rees DC, Cox M, Clegg JB. World distribution of factor V Leiden. Lancet 1995; 346: 1133-4.
• 11 Beauchamp NJ, Daly ME, Hampton KK, Cooper PC, Preston FE, Peake IR. High prevalence of a mutation in the factor V gene within the U.K. population: relationship to activated protein C resistance and familial thrombosis. Br J Haematol 1994; 88: 219-22.
• 12 Bokarewa MI, Bremme K, Blombäck M. Arg506-Gln mutation in factor V and risk of thrombosis during pregnancy. Br J Haematol 1996; 92: 473-8.
• 13 de Boer K, Büller HR, ten Cate JW, Levi M. Deep vein thrombosis in obstetric patients: diagnosis and risk factors. Thromb Haemost 1992; 67: 4-7.
• 14 Hellgren M, Svensson PJ, Dahlbäck B. Resistance to activated protein C as a basis for venous thromboembolism associated with pregnancy and oral contraceptives. Am J Obst Gynecol 1995; 173: 210-3.
• 15 Hirsch DR, Mikkola KM, Marks PW, Fox EA, Dorfman DM, Ewenstein BM, Gold-haber SZ. Pulmonary embolism and deep venous thrombosis during pregnancy or oral contraceptive use: prevalence of factor V Leiden. Am Heart J 1996; 131: 1145-8.