How do you recognize a calf thrombosis in pregnancy?
Also during pregnancy, the signs of a calf thrombosis are pain in the calf, restricted movement, swelling and redness of the affected leg. If symptoms of this kind occur, a doctor should be consulted urgently, as there is an increased risk of thrombosis, especially during pregnancy. With the help of an ultrasound of the leg vessels, the doctor can rule out or reliably determine a calf thrombosis.
What is done if a calf thrombosis is diagnosed?
After a calf thrombosis has been detected, immediate treatment measures should be initiated. On the one hand, the calves should be compressed with a wrap bandage and later with compression stockings. Calf compression should be performed for 3 months.
In addition, the patient should move if possible to prevent the progression of the clot. Another immediate measure is drug therapy. Here, anticoagulant medication is administered for at least five days after the thrombosis is detected.
Low molecular weight heparin or fondaparinux are mainly given for this purpose. Surgical procedures are generally not performed in the case of a calf thrombosis, unless the symptoms are pronounced and the medication does not improve. After the immediate therapy, anticoagulants are taken in tablet form as a preventive measure (oral therapy). How long the anticoagulation inhibition is continued depends on risk factors and concomitant diseases as well as pre-existing conditions, especially with regard to previous thromboses. Thus, the treatment varies between 3-6 months.
Causes of a calf thrombosis
How a thrombosis develops is described by the so-called Virchow Triad. On the one hand, the change in the vessel walls (for example due to inflammation) is decisive. On the other hand, the slowing down of the blood flow velocity (for example due to immobilization or external pressure on the legs) is one of the causes that promote the formation of thrombosis.The third cause is a change in the blood composition (for example, due to genetic diseases or medication).
Whether or not a calf thrombosis occurs also depends on certain risk factors, which can ultimately lead to the Virchow Triad. For example, the risk is increased if the legs are immobilized or immobilized for a longer period of time, as is the case after an operation or on a long-haul flight. In this case, the flow velocity of the blood decreases, whereby the blood sinks into the legs, making thrombus formation more likely.
Overweight (obesity) with a BMI of more than 30 is also more likely to develop thrombosis, as damage to the vessel walls can occur. In the case of cancer – particularly of the stomach, pancreas, lungs and lymphomas – the formation of clot-activating tumor proteins also increases the risk of thrombosis. Estrogen therapy – for contraception with the pill or during menopause – can increase the risk of thrombosis in the calf, especially in combination with nicotine (smoking).
In the so-called antiphospholipid syndrome, an autoimmune disease leads to an increased risk of thrombosis. Antiphospholipids are antibodies that bind to phospholipids and then reduce the function of anticoagulant proteins. This then leads to increased thrombus formation.
Furthermore, the risk of thrombosis during pregnancy and the puerperium is increased by the hormonal changes. There may also be an inherited increased tendency to thrombosis (thrombophilia). In this case, certain proteins involved in clotting are present in too much, or there are too few anticoagulant proteins. The defect can be pronounced to varying degrees.
