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Thromb Haemost 2020; 120(10): 1454-1462
DOI: 10.1055/s-0040-1714211
Stroke, Systemic or Venous Thromboembolism

Clinical Characteristics and Outcomes of Women Presenting with Venous Thromboembolism during Pregnancy and Postpartum Period: Findings from the RIETE Registry

Islam Y. Elgendy 
1   Division of Cardiology, Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
,
Annemarie Fogerty
2   Division of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Ángeles Blanco-Molina
3   Department of Internal Medicine, Hospital Universitario Reina Sofía, Córdoba, Spain
,
Vladimir Rosa
4   Department of Internal Medicine, Hospital Universitario Virgen de Arrixaca, Murcia, Spain
,
Sebastian Schellong
5   Department of Medical Clinic, Municipal Hospital of Dresden Friedrichstadt, Dresden, Germany
,
Andris Skride
6   Department of Cardiology, Pauls Stradins Clinical University Hospital, Riga, Latvia
,
José Portillo
7   Department of Internal Medicine, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
,
Patricia Lopez-Miguel
8   Department of Pneumonology, Hospital General Universitario de Albacete, Albacete, Spain
,
Manuel Monreal
9   Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
,
Ido Weinberg
10   Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, United States
› Author Affiliations Funding None.
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Abstract

Although venous thromboembolism (VTE) is a leading cause of maternal mortality, there is a paucity of real-world clinical data on clinical presentation and management of VTE during pregnancy and postpartum period. Using data from the international RIETE (Registro Informatizado Enfermedad Trombo Embólica) registry, pregnant and postpartum women with VTE were identified. Baseline characteristics, risk factors, therapies, and outcomes were compared. From March 2001 to July 2019, 596 pregnant and 523 postpartum women had symptomatic, objectively confirmed VTE. Pregnant or postpartum women were less likely to have another risk factor for VTE (i.e., immobility, cancer, recent travel) than nonpregnant women aged < 50 years. The prevalence of thrombophilia was higher among pregnant and postpartum women compared with nonpregnant women (53.2% vs. 46%). Pulmonary embolism (PE) was less commonly diagnosed in pregnant versus postpartum women (27% vs. 42%). Pregnant women with PE were commonly treated with low molecular weight heparin (73% vs. 29%), and received more inferior vena cava filters (6.0% vs. 4.2%) compared with postpartum women. By 90 days, one pregnant and one postpartum woman died after PE, and one died after a deep venous thrombosis. The incidence of recurrent VTE was low. In this largest cohort of pregnant and postpartum women with confirmed VTE, we found that pregnant and postpartum women with VTE were unlikely to present with other risk factors for VTE. Adverse outcomes in our study were uncommon.

Keywords

pregnancy - postpartum - pulmonary embolism - venous thromboembolism

Note

The investigators of the RIETE Registry could be found in [Supplementary Appendix A] (available in the online version).


Supplementary Material



Publication History

Received: 25 March 2020

Accepted: 01 June 2020

Article published online:
27 July 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Stuttgart · New York

 

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