Pregnancy and the Postpartum Period

It has been estimated that 1 in 2000 women develop thrombosis during pregnancy. This risk increases 10 times when compared with nonpregnant women of the same age [23, 30]. This risk also goes up in the postpartum period. Pregnancy leads to increased levels of the blood clotting factors I, VII, VIII, IX, X, XI and XII, an increased platelet count and reduced protein S and anti-thrombin concentrations. Further, the fibrinolytic pathway may be blocked by the increased levels of activated plasminogen inhibitors 1 and 2, produced in the placenta. These factors, combined with the venous stasis produced by compression by the uterus of draining leg veins, can increase the risk of thrombosis during the prepartum period by up to 20 times. Some 2 months after childbirth, fibrinolytic and coagulation systems return to their normal state.

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