Thrombotic Diseases

This is a condition when there is clot formation in the veins, usually of the legs and pelvis. It may be due to infection in the vein is referred to as Thrombophlebitis. In the absence of infection in the vein, it is described as Phlebothrombosis.

Thrombophlebitis

This is the inflammation that occurs in a vein at a site of blood clot. Conditions that lead to clot formation are venous stasis or diminished flow. Clotting factors change during pregnancy due to homornal changes

Women at risk include those:

Women who have used contraception before getting pregnant

Women with jobs where they sit for a long period.

Obese women

Prolonged bed rest in pregnancy

Prolonged period of immobility e.g. in Caesarean Section and polyhydramnious

· Older women than 40 years of age

· Anaemia, heart diseases are also predisposed.

There are two types

· Superficial and

· Deep vein thrombosis.

Superficial Thrombophlebitis:

It occurs in the superficial vein of the legs. It is firmly attached to the vein so not likely to break off and travel occurs more 3-4 days post partum.

Symptoms include – reddened, warm, swollen area ove r the clot. The vein is palpable and very tender. It does not require anti coagulant therapy.

Deep Vein Thrombosis (DVT):

It occurs in the large veins often without inflammation clot is much more likely to break off and travel to the lungs and cause pulmonary embolism, which is a fatal complication.

Symptoms include pain in the involved area. Low grade fever, swelling or paleness of the affected leg, Homan’s sign (calf pain on dorsiflexion of the foot) is a positive sign. Ultrasound scanning will confirm diagnosis. It is a serious condition that requires anticoagulants, bed rest, analgesia and observation. Early diagnosis and treatment can reduce the incidence of emboli. It takes 4-6 weeks to resolve completely.