Abstract: . . .  to lymphatic obstruction and increase in intravascular blood volume rather than DVT 3 . In fact, DVTin pregnancy may present atypically with diffuse abdominal pain 9 . Dyspnoea, a common symptom of DVT, is experienced by nearly 3/4th of females during normal pregnancy 10 . Such frequent and non-specific manifestations can easily create a diagnostic enigma for the clinicians. Can non-invasive tests confirm the diagnosis of DVT? In the last decade, non-invasive diagnostic studies such . . .
. . .  microophthalmia, and blindness also have been reported 22 . It can also cause foetal and neonatal haemorrhage and placental abruption. Warfarin can also cause major maternal bleeding and its action is not as easily reversed as that of heparin. Therefore, its use during first trimester is absolutely contraindicated, though the use during 2nd and 3rd trimester is somewhat controversial. Preferably, its use during pregnancy should be avoided unless specifically indicated. It is not secreted in the milk, thus is safe for use during lactation. . . .
. . .  workup for thrombophilia is not indicated in all cases of DVT in pregnancy, but only in selected patients with clinical indicators of hypercoagulable state (Table II). Table II : Clinical indicators of thrombophilias. Family H/O thrombosis Recurrent thrombosis Idiopathic thrombosis Thrombosis at unusual sites (e.g., axillary, cerebral, mesenteric, portal, hepatic veins) Skin necrosis after starting warfarin therapy Management of DVT in pregnancy What are the aims of the treatment of DVT? Aims are : 1. To . . .
. . .  27. Hirsh J, Lenie MN. Low molecular weight heparin. Blood 1992; 79: 1-17. 28. Prandoni P, Lensing AW et al . Comparison of subcutaneous LMWH with i/v standard heparin in proximal vein thrombosis . Lancet 1992; 339: 441-5. 29. Lindmarker P. Can all patients with deep vein thrombosis receive LMWH in an outpatient setting? Haemostasis 1999; 29 (Suppl 1): 84-8. 30. Tengbor L, Brqvist D, Matgsch R et al . Recurrent thromboembolism in pregnancy and puerperium. Am J Obstet Gynaecol 1985; 28: 107-18.  . . .
. . .  Francalanci I, Comeglio P, Liotta AA et al . D dimer concentration during normal pregnancy, as measured by ELISA. Thromb Res 1995; 78: 399-405. 17. Raes DC, Cox M, Clegg JB. World distribution of factor V Leiden. Lancet 1995; 346: 1133-4. 18. Wessler S. Medical management of venous thrombosis . Ann Rev Med 1976; 27: 313. 19. Villasanta U. Thromboembolic disease in pregnancy. Am J Obstet Gynecon 1965; 93: 142. 20. Sellman JS, Holman RL. Thromboembolism during pregnancy : risk, challenges and recommendations. Postgrad Med 2000; 108 (4): . . .
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