Objective:

To conduct a review of the published literature on the treatment of inferior vena cava thrombosis in pregnancy.

Materials and methods:

Case description of inferior vena cava thrombosis in a woman with term pregnancy coming to a private level IV referral centre. It was initially managed with low-molecular weight heparin, which was discontinued 24 hours before delivery. Although the perinatal outcome was good, the patient developed postpartum bleeding and perineal haematoma. Endovascular treatment for thrombolysis and attempted thrombectomy was performed later. A review of the literature was conducted using the terms “inferior vena cava”, “vena cava filters”, “thrombosis” and “pregnancy”. Case reports and case series in English and Spanish were included. All the cases describing the treatment used in women with vena cava thrombosis diagnosed during pregnancy or the postpartum period were selected.

Results:

Overall, 17 publications that met the search criteria were included, and 41 cases were identified: 35 patients were diagnosed with inferior vena cava thrombosis during pregnancy and 6 were identified during the postpartum period. Low molecular weight heparin or unfractionated heparin was used for anticoagulation in 100 % of the patients; 34 pregnant women required inferior vena cava filter for peripartum management, and only one patient needed thrombectomy.

Conclusion:

Peripartum inferior vena cava thrombosis is challenging from the therapeutic point of view. There is a need to balance the risk of pulmonary thromboembolism and massive bleeding. Adequate coordination between the different services involved is mandatory in order to ensure maximum safety and avoid complications.

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