Use of a temporary inferior vena cava filter during pregnancy in patients with thromboembolic events

Abstract

There are circumstances in the management of thromboembolic events during pregnancy when anticoagulant therapy is either contraindicated or not advisable, such as when pulmonary embolism (PE) or deep venous thrombosis is diagnosed close to term, given the risk of bleeding during delivery. In these cases, the thromboembolic risk can be controlled using temporary inferior vena cava filters (T-IVCFs). We present the case of a pregnant woman with thrombophilia who remained at rest for eight weeks due to an amniotic prolapse and for whom the placement of a T-IVCF was decided at 32 weeks’ gestation after anticoagulant therapy had failed. An emergency caesarean section was performed at 33 weeks’ gestation due to placental abruption following the spontaneous onset of preterm labour. The risk of bleeding during delivery when high doses of heparin are used, and the risk of PE when the heparin dose is decreased, needs to be evaluated versus the risks related to T-IVCF placement procedure and, as such, a review of the published experience in this field is warranted. We have concluded that T-IVCFs can be a safe alternative treatment for pregnant women in whom anticoagulation therapy is either contraindicated or not advisable.

Keywords::

• Deep venous thrombosis in pregnancy
• pulmonary embolism in pregnancy
• temporary inferior vena cava filter
• thromboembolic events in pregnancy

Acknowledgements

The authors wish to acknowledge the contribution of the nursing and midwifery staff of Malaga University Hospital for the resolution of the clinical case presented.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.