Topic overview

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Pregnancy-associated DVT is most common in the third trimester and early postpartum period. Previous venous thromboembolism, thrombophilia, obesity, immobility, cesarean delivery, and other listed factors can increase risk. Unilateral leg pain or swelling should prompt assessment; dyspnea or pleuritic pain raises concern for pulmonary embolism. Compression duplex ultrasound is the first-line imaging approach, while D-dimer is difficult to interpret in pregnancy. The lesson focuses on low-molecular-weight heparin as the preferred treatment, situations where unfractionated heparin may be considered, and why warfarin and direct oral anticoagulants are unsuitable during pregnancy. It also addresses treatment duration, delivery and neuraxial-anesthesia timing, postpartum prophylaxis, monitoring, and safety.