Association Between Venous Thrombosis (VT) and Pregnancy: A Literature Review
Hubungan Antara Trombosis Vena (VT) dan Kehamilan: Sebuah Tinjauan Literatur
-
(1) * Noor Salman Dalis
Physiology Department, Collage of Medicine, University of Tikrit, Iraq
Iraq
(*) Corresponding Author
Abstract
The incidence of VTE varies across countries, with Eastern regions generally reporting lower rates. In pregnancy, a combination of intrinsic factors, such as hormonal changes, increased blood clotting tendency, and genetic predispo-sitions, along with environmental factors like lifestyle and healthcare access, can trigger VTE through various, often overlapping mechanisms. The precise role of certain risk factors and their interactions during pregnancy remains un-clear and warrants further study. Ongoing research into pregnancy-related VTE is crucial due to the considerable number of idiopathic cases and the need to refine risk stratification methods. Understanding how different risk factors interact during pregnancy can lead to more effective prevention strategies and targeted treatments. As new risk factors are identified, they may help clarify the underlying mechanisms of VTE in pregnancy, particularly in cases where the cause is unknown. Additionally, improving risk stratification not only helps prevent the initial occurrence of VTE in pregnant women but also plays a vital role in reducing the likelihood of recurrence, ultimately leading to better out-comes for both the mother and the child, as well as more efficient use of healthcare resources.
Highlights:
- VTE in Pregnancy: Hormonal, genetic, and environmental factors contribute.
- Research Needs: Clarify interactions, refine risk stratification, prevent idiopathic cases.
- Outcomes: Better maternal-child health, reduced recurrence, efficient healthcare use.
Keywords: Venous thrombosis, Thrombosis, Cerebral Venous Sinus Thrombosis, Coagulation, pregnancy.
References
G. Standby and L. R., "Effect of testing for cancer on cancer‐ or venous thromboembolism (VTE)‐related mortality and morbidity in people with unprovoked VTE," Cochrane Database Syst. Rev., vol. 2021, no. 10, p. CD010837, 2021.
B. Durmus and L. Y., "Cerebral venous thrombosis in women of childbearing age: diagnosis, treatment, and prophylaxis during a future pregnancy," Ther. Adv. Neurol. Disord., vol. 13, p. 1756286420945169, 2020.
K. Haug et al., "MetaboLights: a resource evolving in response to the needs of its scientific community," Nucleic Acids Res., vol. 48, no. D1, pp. D440–D444, 2020.
W. Liu et al., "Peripherally inserted central venous catheter in upper extremities leads to an increase in D-dimer and deep vein thrombosis in lower extremities," Thrombosis J., vol. 19, no. 1, pp. 1–8, 2021.
M. Bellesini et al., "D‐dimer to rule out venous thromboembolism during pregnancy: a systematic review and meta‐analysis," J. Thromb. Haemost., vol. 19, no. 10, pp. 2454–2467, 2021.
N. Kiriakopoulos et al., "Investigating stress response during vaginal delivery and elective cesarean section through assessment of levels of cortisol, interleukin 6 (IL-6), growth hormone (GH), and insulin-like growth factor 1 (IGF-1)," J. Clin. Med., vol. 8, no. 8, p. 1112, 2019.
N. S. Ali et al., "Venous thromboembolism-incidence of deep venous thrombosis and pulmonary embolism in patients with head and neck cancer: a tertiary care experience in Pakistan," Int. Arch. Otorhinolaryngol., vol. 19, pp. 200–204, 2015.
A. A. Penka, I. R. Massaldjieva, T. N. Chalakova, and D. B. Dimitrov, "Cerebral Venous Sinus Thrombosis—Diagnostic Strategies and Prognostic Models: A Review," 2012.
N. M. A. Ibrahim, A. Z. El-Shahawy, and A. Elshabacy, "Risk of Cerebral Venous Thrombosis in Oral Contraceptive Pills Users," J. EJRNM, 2018.
L. Amalia, "The Role of Platelet-Selectin as a Marker of Thrombocyte Aggregation on Cerebral Sinus Venous Thrombosis," J. Blood Med., vol. 13, pp. 267, 2022.
C. Weimar, F. Masuhr, and K. Hajjar, "Diagnosis and treatment of cerebral venous thrombosis," Exp. Rev. Cardiovasc. Ther., vol. 10, no. 12, pp. 1545–1553, 2012.
H. M. A. M. ElBassossy, "Psiadia punctulata major flavonoids alleviate exaggerated vasoconstriction produced by advanced glycation end products," PLoS One, 2019.
H. Stevens and J. D. McFadyen, "Platelets as Central Actors in Thrombosis—Reprising an Old Role and Defining a New Character," Seminars in Thrombosis and Hemostasis, vol. 45, no. 8, pp. 802–809, 2019, Thieme Medical Publisher.
C. Karatoprak, S. Uyar, G. B. Abanonu, S. Pehlevan, M. Mengüç, A. Daşkin, ... and R. Demirtunç, "Elevated Beta-Thromboglobulin and Mean Platelet Volume Levels May Show Persistent Platelet Activation in Systemic Lupus Erythematosus Patients," 2018.
H. Rennert and R. A. DeSimone, "Molecular Testing for Factor V Leiden and Prothrombin Gene Mutations in Inherited Thrombophilia," in Transfusion Medicine and Hemostasis, Elsevier, 2019, pp. 903–906.
J. Wojta, "Commentary on 'Elevated Plasma Levels of Plasminogen Activator Inhibitor‐1 Are Associated with Risk of Future Incident Venous Thromboembolism': A New Role for Plasminogen Activator Inhibitor‐1—An Inhibitor of Fibrinolysis Predicts Future Venous Thromboembolic Events and Links Them to Obesity," Journal of Thrombosis and Haemostasis, vol. 20, no. 7, p. 1559, 2022.
S. N. Patel and A. Shander, "Physiology and Pathology of Coagulation in Pregnancy," in Principles and Practice of Maternal Critical Care, Springer, Cham, 2020, pp. 47–57.
M. Sillen and P. J. Declerck, "Thrombin Activatable Fibrinolysis Inhibitor (TAFI): An Updated Narrative Review," International Journal of Molecular Sciences, vol. 22, p. 3670, 2021, doi: 10.3390/ijms22073670.
J. Padda, K. Khalid, A. Mohan, S. Pokhriyal, N. Batra, G. Hitawala, ... and G. Jean-Charles, "Factor V Leiden G1691A and Prothrombin Gene G20210A Mutations on Pregnancy Outcome," Cureus, vol. 13, no. 8, 2021.
H. O. Elzein, A. A. Saad, A. A. Yousif, E. Elamin, E. K. Abdalhabib, and S. E. G. Elzaki, "Evaluation of Factor V Leiden and Prothrombin G20210A Mutations in Sudanese Women with Severe Preeclampsia," Current Research in Translational Medicine, vol. 68, no. 2, pp. 77–80, 2020.
B. Tesfamariam, "Involvement of Vitamin K-Dependent Proteins in Vascular Calcification," Journal of Cardiovascular Pharmacology and Therapeutics, vol. 24, no. 4, pp. 323–333, 2019.
L. Wen, J. Chen, L. Duan, and S. Li, "Vitamin K-Dependent Proteins Involved in Bone and Cardiovascular Health," Molecular Medicine Reports, vol. 18, no. 1, pp. 3–15, 2018.
A. Latona, K. Hill, A. Connelly, K. Stuart, and P. Wood, "Prothrombinex®‐VF in Chronic Liver Disease: Friend or Foe?," Emergency Medicine Australasia, 2022.
A. Siennicka, M. Kłysz, K. Chełstowski, A. Tabaczniuk, Z. Marcinowska, P. Tarnowska, J. Kulesza, A. Torbe, and M. Jastrzębska, "Reference Values of D-Dimers and Fibrinogen in the Course of Physiological Pregnancy: The Potential Impact of Selected Risk Factors—A Pilot Study," Biomed Research International, vol. 2020, p. 3192350, 2020.
F. I. Mulder, N. van Es, N. Kraaijpoel, M. Di Nisio, M. Carrier, A. Duggal, and G. Raskob, "Edoxaban for Treatment of Venous Thromboembolism in Patient Groups with Different Types of Cancer: Results from the Hokusai VTE Cancer Study," Thrombosis Research, vol. 185, pp. 13–19, 2020.
U. Baboolall, Y. Zha, X. Gong, D. R. Deng, F. Qiao, and H. Liu, "Variations of Plasma D-Dimer Level at Various Points of Normal Pregnancy and Its Trends in Complicated Pregnancies: A Retrospective Observational Cohort Study," Medicine, vol. 98, no. 23, pp. e15939, 2019.
E. V. Kane, C. Calderwood, R. Dobbie, C. Morris, E. Roman, and I. A. Greer, "A Population-Based Study of Venous Thrombosis in Pregnancy in Scotland 1980–2005," Eur. J. Obstet. Gynecol. Reprod. Biol., vol. 169, no. 2, pp. 223–229, 2015.
M. Gusenbauer and N. R. Haddaway, "Which Academic Search Systems Are Suitable for Systematic Reviews or Meta‐Analyses? Evaluating Retrieval Qualities of Google Scholar, PubMed, and 26 Other Resources," Res. Synth. Methods, vol. 11, no. 2, pp. 181–217, 2020.
B. Singh and P. Kaur, "COVID-19 and Acute Mesenteric Ischemia: A Review of Literature," Hematol. Transfus. Cell Ther., vol. 43, pp. 112–116, 2021.
R. Sztajzel, A. Coeytaux, A. R. Dehdashti, J. Delavelle, and M. Sinnreich, "Subarachnoid Hemorrhage: A Rare Presentation of Cerebral Venous Thrombosis," Headache: J. Head Face Pain, vol. 41, no. 9, pp. 889–892, 2021.
P. Tadi, B. Behgam, and S. Baruffi, Cerebral Venous Thrombosis. Treasure Island, FL, USA: StatPearls Publishing, 2024. [Online]. Available: https://www.ncbi.nlm.nih.gov/books/NBK459315/
N. Nisio and O. Page, "Improving Functional Validation Through Analyses of Operational Problems," in 2018 SpaceOps Conf., 2018, p. 2422.
N. S. Evans and E. V. Ratchford, "Catheter-Related Venous Thrombosis," Vasc. Med., vol. 23, no. 4, pp. 411–413, 2018.
S. P. S. Dhami et al., "Breast Cancer Cells Mediate Endothelial Cell Activation, Promoting Von Willebrand Factor Release, Tumor Adhesion, and Transendothelial Migration," J. Thromb. Haemost., 2022.
P. Song, Y. Xu, M. Zha, Y. Zhang, and I. Rudan, "Global Epidemiology of Retinal Vein Occlusion: A Systematic Review and Meta-Analysis of Prevalence, Incidence, and Risk Factors," J. Global Health, vol. 9, no. 1, 2019.
E. Keohane, C. N. Otto, and J. Walenga, Rodak's Hematology-E-Book: Clinical Principles and Applications. St. Louis, MO, USA: Elsevier Health Sciences, 2019.
M. Gallardo et al., "Machine Learning Can Predict Anti–VEGF Treatment Demand in a Treat-and-Extend Regimen for Patients with Neovascular AMD, DME, and RVO Associated Macular Edema," Ophthalmol. Retina, vol. 5, no. 7, pp. 604–624, 2021.
M. Yunce, A. Sharma, E. Braunstein, M. B. Streiff, and Y. W. Lum, "A Case Report on 2 Unique Presentations of Upper Extremity Deep Vein Thrombosis," Medicine (Baltimore), vol. 97, no. 11, 2018.
C. E. A. Dronkers et al., "Diagnosing Upper Extremity Deep Vein Thrombosis with Non-Contrast-Enhanced Magnetic Resonance Direct Thrombus Imaging: A Pilot Study," Thromb. Res., vol. 163, pp. 47–50, 2018.
W. Liu et al., "Peripherally Inserted Central Venous Catheter in Upper Extremities Leads to an Increase in D-Dimer and Deep Vein Thrombosis in Lower Extremities," Thromb. J., vol. 19, no. 1, p. 1, 2021.
F. Turon et al., "Predicting Portal Thrombosis in Cirrhosis: A Prospective Study of Clinical, Ultrasonographic, and Hemostatic Factors," J. Hepatol., vol. 75, no. 6, pp. 1367–1376, 2021.
P. G. Northup et al., "Vascular Liver Disorders, Portal Vein Thrombosis, and Procedural Bleeding in Patients with Liver Disease: 2020 Practice Guidance by the American Association for the Study of Liver Diseases," Hepatol., 2021.
E. Azouz, S. Yang, L. Monnier-Cholley, and L. Arrivé, "Systemic Arterial Thrombosis and Acute Mesenteric Ischemia in a Patient with COVID-19," Intensive Care Med., vol. 46, no. 7, pp. 1464–1465, 2020.
A. Mukherjee, R. Ghosh, and M. M. Furment, "Case Report: COVID-19 Associated Renal Infarction and Ascending Aortic Thrombosis," Am. J. Trop. Med. Hyg., vol. 103, no. 5, p. 1989, 2020.
T. Andreea, F. Anca, and L. Liviu, "Management of Postpartum Extensive Venous Thrombosis After Second Pregnancy," Medicina (Kaunas), vol. 59, no. 5, p. 871, 2023.
S. K. Zachariah et al., "Management of Acute Abdomen in Pregnancy: Current Perspectives," Int. J. Women's Health, vol. 11, pp. 119–126, 2019.
W. F. Rayburn, J. C. Klagholz, C. Murray-Krezan, L. E. Dowell, and A. L. Strunk, "Distribution of American Congress of Obstetricians and Gynecologists Fellows and Junior Fellows in Practice in the United States," Obstetrics & Gynecology, vol. 119, no. 5, pp. 1017–1022, 2012.
S. Chauhan, B. Rishi, P. Tanwar, G. Mehdi, S. H. Arif, T. Rabbani, and A. Misra, "Therapeutic Lessons From Transfusion in Pregnancy—Effect on Hematological Parameters and Coagulation Profile," American Journal of Blood Research, vol. 11, no. 3, p. 303, 2021.
M. R. Helvaci, O. Tonyali, A. Abyad, and L. Pocock, "The Safest Value of Plasma Triglycerides," World Family Medicine, vol. 17, no. 7, pp. 22–27, 2019.
L. J. Yockey and A. Iwasaki, "Interferons and Proinflammatory Cytokines in Pregnancy and Fetal Development," Immunity, vol. 49, no. 3, pp. 397–412, 2018.
A. Baskiran, V. Ince, E. Cicek, T. Sahin, A. Dirican, I. Balikci Cicek, and S. Yilmaz, "Efficacy of Laboratory Tests and Ultrasonography in the Diagnosis of Acute Appendicitis in Gravid Patients According to the Stages of Pregnancy," World Journal of Emergency Surgery, vol. 13, no. 1, p. 24, 2018.
M. N. Shahbazi, "Mechanisms of Human Embryo Development: From Cell Fate to Tissue Shape and Back," Development, vol. 147, no. 14, p. dev190629, 2020.
