BLOOD CLOTTING TENDENCIES AND RISKS IN PREGNANCY
From the first months of pregnancy, clotting activity in the body begins to increase and continues to increase as the pregnancy progresses. This occurs when the effect of anti-coagulation mechanisms decreases compared to before pregnancy, along with the increase in some substances that promote blood clotting. In addition, proper disintegration of a clot that has already formed may become more difficult, especially in the last 3 months of pregnancy. These changes in the hemostatic system act as a physiological “safety net” for the pregnancy period, but in at-risk individuals, they may predispose both mother and fetus to complications during pregnancy. According to some data, this risky situation may continue up to 12 weeks after pregnancy.
Risks for the fetus during pregnancy include preeclampsia, placental abruption, developmental delay, recurrent early miscarriages in the late and early periods, intrauterine death and stillbirth. .
Pregnant women have a 5-6 times higher risk of venous thromboembolism (blood clot formation in the veins) than non-pregnant women of the same age. Pregnancy-related venous thrombosis occurs in approximately one in every 1000 births, and one in every 1000 women experiences thrombosis in the postpartum period. Additionally, the risk of venous thromboembolism is higher in cesarean births than in vaginal births. The most important risk factors for increased clotting tendency during pregnancy are a previous history of venous thromboembolism and hereditary thrombophilia. Hereditary thrombophilia refers to genetic problems that increase the risk of blood clots forming more easily than in normal people. It is one of the main causes of hereditary thrombophilia such as antithrombin, protein S, protein C deficiency, Factor 5 Leiden mutation, and Prothrombin gene mutation. A significant portion of patients with hereditary thrombophilia may not experience venous thromboembolism throughout their lives, but hereditary thrombophilia factors can be detected in up to 50% of women who experience this disorder during pregnancy. In this respect, an evaluation should be made for hereditary thrombophilia in appropriate cases after thromboembolism during pregnancy.
In addition to hereditary thrombophilia, acquired risk factors are also important. antiphospho lipid syndrome, some heart and lung diseases, Lupus, cancer and inflammatory bowel diseases, some rheumatological diseases, nephrotic syndrome, sickle cell anemia, obesity, being over 35 years of age, multiple pregnancy, use of assisted reproductive techniques, smoking, advanced varicose veins. Situations such as surgical intervention during pregnancy and post-pregnancy follow-up, dehydration, long-distance travel, long-term infection can be counted among the risk factors that develop later.
Women who are at risk for thromboembolism must have this treatment before birth. It is necessary to receive counseling and appropriate cases should be evaluated for prophylactic treatment during and after pregnancy.
SUMMARY SENTENCE: Coagulation activity in the body begins to increase from the first months of pregnancy and continues to increase as the pregnancy progresses. Pregnant women suffer from venous thromboembolism (venous thromboembolism ( They have a 5-6 times higher risk of blood clot formation in the veins than non-pregnant women of the same age. The most important risk factors for increased clotting tendency during pregnancy are a previous history of venous thromboembolism and hereditary thrombophilia. Women who are at risk for thromboembolism must receive counseling in this regard before birth, and suitable cases should be evaluated for prophylactic treatment during and after pregnancy.
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