Abstract
Thromboembolic disease accounts for half of the obstetric mortality in the US The reported incidence of thromboembolic complications during pregnancy and the Puerperium vary widely and likely reflect both the methodology and diligence with which the diagnosis was sought. The overall incidence of thromboembolic disease may be similar in the pregnant and nonpregnant postoperative population, and the higher incidence of symptomatic disease in the latter the result of chronic stasis and hypercoagulability. The clinical diagnosis of thromboembolic disease must be confirmed by objective testing prior to initiating treatment. Therapy, whether heparin or vitamin K inhibition, can have significant morbidity. The diagnosis of pulmonary embolus is unaltered by pregnancy. Neither the perfusion/ventilation scan nor selective angiography with appropriate shielding of the maternal abdomen from radiation is contraindicated. The difference between proximal and distal thromboses highlights the importance of an accurate diagnosis and localization.