Blood Clots And Pregnancy: An Avoidable Cause of Maternal Death

Recently, I talked with a friend who was sharing with me how she lost her sister. My heart sank to the floor when she said: “She was seven weeks pregnant and died from a pulmonary embolus.” As a physician who takes care of women with complicated pregnancies, I was shocked by what she said. As a human being, I was touched and saddened by her loss. Women in the US should not die from a diagnosable and preventable condition.

What is deep vein thrombosis/pulmonary embolus?
Deep vein thrombosis/pulmonary embolus (DVT/PE) is a preventable and treatable cause of death in pregnancy; yet, it continues to be one of the most common reasons for maternal mortality in the US. A DVT is a blood clot that forms in the veins. When a blood clot forms, the danger is that a piece of the clot can break off (an embolus), travel to other organs (such as the lungs or brain) and interrupt the flow of oxygen to a pregnant woman and her unborn child. Unlike other causes of maternal death, the symptoms can be identified and the condition can be treated. Death does NOT have to happen. People have to be aware and health care providers have to listen.

Am I at risk for DVT/PE?
If you are pregnant, the answer is YES! There are many reasons why blood clots may form, including:

  • A genetic predisposition (someone in your family has a blood clot causes by a genetic disorder)
  • A circulating antibody that can cause your blood to clot
  • Obesity
  • Long trips with no activity
  • Smoking
  • PREGNANCY

The normal changes that occur in pregnancy significantly increase a woman’s risk of having a blood clot during her pregnancy and up to six weeks after delivery.

What symptoms should I worry about?
Katie’s story has been immortalized on a website (www.katiesvoice.org) created by her sister, who is determined to spread the word and increase awareness about the signs and symptoms of DVT/PE as well as the importance of early recognition and treatment. Katie’s story is unfortunately not a unique one; every year, one out of every 100,000 pregnant women will die from DVT/PE related to pregnancy. The symptoms CAN BE RECOGNIZED. They include: leg swelling, calf tenderness, redness of the skin, difficulty breathing, and rapid heartbeat.

What can I do?
When in doubt, ask your health care provider. If the symptoms persist and there is no further assessment, ask again or get a second opinion. If a sibling, parent or other relative has had a blood clot, tell your health care provider. This information is important as you may have an inherited risk for having a blood clot.

Other resources on the web:

  • National Blood Clot Alliance – Stop the Clot
  • American Society of Hematology – Blood Clotting and Pregnancy

Stephanie Mann, MD, is an Attending Perinatalolgist at Fletcher Allen Health Care and Assistant Professor in the Division of Maternal Fetal Medicine in Obstetrics and Gynecology at the University of Vermont College of Medicine. She specializes in taking care of women with pregnancy-related medical and/or fetal complications.