Development Of The Diagnosis And Management Of Obstetrical Venous Thromboembolism

Venous thromboembolism(VTE) is one of the serious complications of women during pregnancy and the puerperium, which threatens maternal safety, even leads to maternal death, including deep vein thrombosis(DVT) and pulmonary embolism(PE). DVT patients often suffer from pain, swelling suddenly in the side limb, even impaired walking. Once the embolus from the limb into the lungs, blocking the pulmonary artery branch, namely PE, which is a fatal disease. Dyspnea, chest pain, hemoptysis and panic are common symptoms. The prevalence of maternal VTE is 0.1%-0.2%, but resulted in 10%-15% maternal death. Because of the potential lethality of the disease, we need to attach great importance to the disease. Compression ultrasonography, magnetic resonance imaging(MRI), ventilation/perfusion(V/Q) imaging, computed tomography pulmonary angiography(CTPA) are the diagnostic method of maternal VTE, but most procedures may increase the risk of adverse pregnancy outcomes due to the radiation. Optimal management of VTE is anticoagulation, which needs subcutaneous injection, it’s inconvenience, and has many side effects. Vena caval filters, thrombolysis are limited treatment due to the lack of experience and risk to the fetus. Now it’s extremely urgent to find maternal VTE serological markers, and new noninvasive treatment with less side effects, in addition, to develop the prenatal screening for maternal VTE. In this article the etiology, clinical manifestation, diagnosis, treatment and the development trend of maternal VTE were reviewed.