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postpartum thromboembolism
Etiology:
- low birth weight infant may increase risk (RR=3) [2]
Complications:
- women are hypercoagulable for the first 6-12 weeks postpartum
Management:
- contraception (women not breast-feeding)
- < 21 days postpartum:
- do not use combined hormonal contraceptives due to increased risk for venous thromboembolism
- 21-42 days postpartum:
- if no other risk factors for venous thromboembolism, ok to start combined hormonal contraceptive
- if other risk factors, do not
- > 42 days postpartum: no restrictions
- these guidelines may change
- intrauterine devices & implants offer highly effective reversible contraception without increasing clot risk [1]
General
thromboembolism
complications of the puerperium
References
- Physician's First Watch, Feb 14, 2014
David G. Fairchild, MD, MPH, Editor-in-Chief
Massachusetts Medical Society
http://www.jwatch.org
- Kamel H et al.
Risk of a thrombotic event after the 6-week postpartum
period.
N Engl J Med 2014 Feb 13;
PMID: 24524551
- Blondon M et al.
Association between newborn birthweight and the risk of
postpartum maternal venous thromboembolism: A population-
based case-control study.
Circulation 2015 Mar
PMID: 25745022