Thromboembolism remains a major cause of maternal mortality. Duplex Doppler ultrasound is now established as the first line investigation for deep vein thrombosis (DVT) in pregnancy, but interpretation has been hampered by the lack of contemporary data describing the normal appearance of the deep leg veins in pregnancy. Gestational changes in the deep leg veins may contribute to the increased risk of DVT associated with pregnancy and the puerperium. In this article, recent data derived from duplex Doppler studies are presented. The profound effects of pregnancy include a 40% reduction in the maximum flow velocity through the common femoral vein. Venous flow velocity is shown to be reduced in the left leg in comparison to the right, but adoption of the lateral supine position in pregnancy is observed to increase flow velocity in both common femoral veins. The postpartum period is also shown to be associated with characteristic alterations in the deep leg veins. The possible significance of these observations is discussed in the context of the pathophysiology, diagnosis and prevention of DVT in pregnancy and the puerperium.
|Tidsskrift||Contemporary Reviews in Obstetrics and Gynaecology|
|Status||Udgivet - 1 jan. 1997|