Pulmonary embolisms during pregnancy
Pulmonary embolisms are one of the most common causes of death during pregnancy. During pregnancy and after delivery, the woman has a greatly increased risk of pulmonary embolism. The reasons for this are that during the process of pregnancy the woman’s body undergoes extreme changes.
As a prophylaxis, the pregnant woman can be anticoagulated (administration of anticoagulants). This should be continued for a certain period of time after the birth (6 weeks if an embolism has occurred). Coumarins (Marcumar®) should not be used to inhibit coagulation during pregnancy, as these can cross the placental barrier – i.e. they can also enter the circulation of the unborn child via the uterus, where they can cause damage to its development.
After an expired embolism, heparins are usually injected into the veins for one week. After that, it is possible to switch to low-molecular-weight heparins, which have the advantage that they can be injected subcutaneously (into the subcutaneous tissue, e.g. the abdomen or buttocks). However, not every woman needs to be treated with heparins out of principle.
It is important to use it in women in whose families thromboses, embolisms and genetic diseases that promote them are known. It is also indispensable for women who have already had an embolism. They should also pay special attention to possible symptoms of pulmonary embolism.
- Firstly, the composition of the blood changes, which increases the risk of thrombus formation.
- On the other hand, the enlarged uterus puts pressure on vessels in the lower abdomen and pelvic area, which changes or slows down the blood flow – this is also a risk factor for thrombosis.
- Another reason is that during pregnancy the woman simply moves less and lies more.
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