Pregnancy has been found to be associated with a 4–5 fold increase in the risk of venous thromboembolism (VTE), due to various physiological changes and VTE has been the leading cause of direct maternal mortality in the UK over the past decade. Management of VTE using an inferior vena cava (IVC) philtre is recommended by the Royal College of Obstetricians and Gynaecologists in women in the perinatal period with iliac vein VTE to reduce the risk of PE, or with proven DVT and continuing PE despite adequate anticoagulation. However, little data currently exists on the safety of IVC philtres during pregnancy.
Data were collected from women who underwent IVC philtre insertion for a VTE during pregnancy (January 2000 – September 2012) in the interventional radiology department at Central Manchester University Hospitals, Manchester.
Nine patients were initially identified, of which six had complete delivery data available. 67% (n = 6) of patients had an acute VTE late in the third trimester, requiring philtre insertion and 56% (n = 5) also had a previous history of VTE. All patients delivered at term; one case was delivered by emergency caesarean section, and the remainder achieved vaginal deliveries. All infants were appropriately grown at birth and 83% (n = 5) had 5 minute APGAR scores of 10. There was one case of philtre retrieval failure.
This case series is concordant with other similar series, and suggests no detrimental effects on pregnancy. However, more research is needed to evaluate the long-term safety profile of IVC philtre use in pregnancy.
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CEMACH, Confidental Enquiry into Maternal and Child Health. Perinatal Mortality 2005: England, Wales and Northern Ireland. 2007: London.
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