Thrombotic diseases pose a significant life-threatening risk as a complication for pregnant and postpartum women, demanding heightened vigilance. Wu Zhidan, from the Obstetrics Department of Shunyi Women and Children’s Hospital, revealed that pregnant and postpartum women who are advanced in age, obese, carrying multiple fetuses, or undergoing cesarean section are at a higher risk of developing thrombosis during pregnancy. Prevention strategies include scientifically planning diets and exercise routines, wearing compression stockings, and elevating the lower limbs during sleep. For pregnant women with a higher risk of thrombosis, medication prevention under the guidance of medical professionals is advisable.
How Does Pregnancy Thrombosis Occur?
During pregnancy, a series of physiological changes in a woman’s body lay the groundwork for thrombosis. In terms of blood components, coagulation factors such as fibrinogen, factor VII, and factor VIII increase, while the levels of anticoagulant substances like antithrombin III relatively decrease, putting the blood in a hypercoagulable state. This hypercoagulable state is a self-protective mechanism of the body to prevent massive bleeding during childbirth, but it also elevates the risk of thrombosis.
In hemodynamics, the enlarged uterus compresses the pelvic veins, obstructing the return of blood in the lower extremities and slowing down blood flow. Additionally, the relatively reduced physical activity during pregnancy further hinders blood circulation. The slow blood flow allows the formed elements in the blood to easily deposit on the vessel wall, leading to thrombosis.
Vascular endothelial cell injury is also a crucial factor in thrombosis. During childbirth, the vascular endothelium may be mechanically damaged, exposing the subendothelial tissue and activating the coagulation system, thus initiating the process of thrombosis.
What Are the Hazards of Thrombosis to Pregnant Women’s Health?
Once formed, a thrombus can impede the normal flow of blood in blood vessels, causing the following hazards:
Frequent lower limb pain and difficulty walking
When a thrombus occurs in the lower limb veins, the most common symptom is leg swelling, usually with one leg significantly thicker than the other. It may be accompanied by pain, which intensifies when standing or walking. The skin may turn red and feel hot, and superficial veins may dilate.
Severe cases leading to fatal pulmonary embolism.
More seriously, if a thrombus breaks off, it can travel through the bloodstream to the lungs, causing a pulmonary embolism. In the event of a pulmonary embolism, patients may suddenly experience shortness of breath, rapid breathing, chest pain, accompanied by coughing and even hemoptysis. In severe cases, it can pose a threat to the life of pregnant and postpartum women.
Impact on the uteroplacental circulation
Thrombosis can also affect the blood supply to the placenta, negatively impacting fetal growth and development, such as causing fetal growth restriction and premature birth.
Which Pregnant Women Are at High Risk of Pregnancy Thrombosis?
Advanced age
Maternal age over 35 means a decline in physical function, reduced vascular elasticity, and relatively higher blood viscosity, making them more prone to thrombosis. Moreover, older pregnant women often have multiple underlying diseases, such as hypertension and diabetes, which further increase the risk of thrombosis.
Obesity
In obese pregnant and postpartum women, the accumulation of body fat not only affects blood circulation but may also lead to metabolic disorders, disrupting the balance of the coagulation and fibrinolysis systems and promoting thrombosis.
Multiple pregnancies
During multiple pregnancies, the maternal blood volume increases more significantly, increasing the burden on the heart. Meanwhile, the uterus exerts more pressure on blood vessels, increasing the likelihood of thrombosis.
Cesarean section
Cesarean section directly damages blood vessels. Post – operatively, due to wound pain, the mobility of women is restricted, further slowing down blood flow, which makes the risk of thrombosis in cesarean – section women significantly higher than that in women who give birth vaginally.
How to Prevent Thrombosis?
Lifestyle prevention
During pregnancy, appropriate exercise, such as walking and prenatal yoga, should be maintained to promote blood circulation. However, it is important to pay attention to the exercise intensity and safety to avoid overexertion. In terms of diet, the intake of high – fat and high – sugar foods should be reduced, and more fiber – rich foods, such as vegetables and fruits, should be consumed. Keeping the bowels regular helps avoid increased abdominal pressure, which may affect the return of blood in the lower extremities.
Physical prevention
Using medical compression stockings is a common physical prevention method. Compression stockings apply different pressures to different parts of the lower extremities.
Physical prevention
Using medical compression stockings is a common physical prevention method. Compression stockings apply different pressures to different parts of the lower extremities, promoting venous return, reducing lower limb edema, and lowering the risk of thrombosis. When resting or sleeping, elevating the lower limbs above the level of the heart also facilitates blood return.
Medication prevention
For pregnant women with a higher risk of thrombosis, doctors may consider medication prevention, such as low – molecular – weight heparin, based on the specific situation. Low – molecular – weight heparin can inhibit the activity of coagulation factors to prevent thrombosis and has minimal impact on the fetus. However, the use of medication must strictly follow medical advice, and indicators such as coagulation function should be closely monitored.
The prevention and treatment of obstetric thrombosis require the joint attention of medical staff, pregnant women, and their families. Pregnant women should actively cooperate with prenatal check – ups, understand their physical conditions, and take effective preventive measures. Once symptoms thrombosis, such as lower limb swelling, pain, or shortness of breath, occur, immediate medical attention should be sought for early diagnosis and treatment to ensure the health of both the mother and the baby.
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