There is nothing quite like the feeling of not being able to catch your breath. When I was 22 years old, I had trouble breathing. I eventually went to the hospital where they diagnosed me with a pulmonary embolism—a blood clot in the lung, a rare condition for a person of my age. I later learned that I had a genetic condition that increased my likelihood of developing a blood clot. Show
My clot was broken up and I was treated for some time afterward with blood thinners, but I knew that in the future I would need to take proactive measures if I were to become pregnant or have surgery. Blood clots during pregnancy are a concern for many expectant mothers, but as I learned, it is possible to manage your high risk. What is a blood clot?Blood clotting is a natural process that occurs when blood clumps together to form a gelatinous mass. This process protects your body from bleeding too much when you’ve been injured, as clotting can seal off the wound. Blood clotting (called thrombosis) can also cause complications, especially when it happens internally in your blood vessels. This can happen in any blood vessel in the body. However, the most common place for abnormal blood clots to occur is in the deep veins of your legs. This is called deep vein thrombosis (DVT). The major concern is that the clot can break free and travel to other parts of the body (lungs are most common), which can lead to serious complications or even death. Why are pregnant women at greater risk of blood clots?In pregnancy, the body is primed to clot to prevent blood loss during delivery. While this is important, it also increases the risk of clotting problematically. It is estimated that pregnant women may be up to five times more likely to experience blood clots than non-pregnant women. There are several reasons for this uptick. Higher-than-normal levels of estrogen during pregnancy are known to increase clotting risk, although the exact mechanism by which this happens is unknown. Also, a woman’s blood clots more easily in preparation for childbirth in order to reduce blood loss at delivery. Restricted blood flow may also raise the likelihood of blood clots. As the baby gets larger during pregnancy, it places more pressure on the blood vessels in the pelvic region, resulting in a restriction of blood flow that can also cause blood clots. If bed rest is required, lack of movement can decrease blood flow to the arms and legs, also increasing risk. A blood clot in the lung, also known as a pulmonary embolism, is a leading cause of maternal death for pregnant women in the U.S., according to the CDC. And the risk of developing blood clots isn’t just during the pregnancy—it continues to be a concern for approximately three months after giving birth. Delivery by cesarean section (C-section) nearly doubles your risk after birth. “Pregnant women are at a higher risk of DVT for several reasons,” says Nisha Bunke, MD, a vein specialist and diplomate of the American Board of Venous and Lymphatic Medicine, “a hypercoagulable state (proteins in the blood make it thicker, and more likely to form clots), an enlarged uterus may put pressure on the veins in the lower abdomen, and the hormones decrease venous tone.” Anyone can develop a blood clot during pregnancy, however it is more likely under certain conditions, or for those who already have some risk factors. Dr. Bunke adds that “some women have risk factors that increase their risk of DVT even more during pregnancy, like inherited blood clotting disorders, medical conditions such as lupus and sickle cell disease, obesity, immobility and age over 35.” Other factors that may increase the risk of clotting during pregnancy are:
What are other risk factors for blood clots?In addition to pregnancy, the following risk factors can increase your risk of developing a blood clot. Acquired:
Genetic:
Condition-related:
Additionally, some people may be predisposed to getting blood clots if they have thrombophilias, a group of disorders that increase a person’s risk of thrombosis (abnormal blood clotting). This was my case, with a condition known as Protein C Deficiency. Symptoms of blood clots during pregnancy“The most obvious symptom of DVT is swelling and heavy pain or extreme tenderness in one of your legs,” says Kendra Segura, MD, a board-certified OB-GYN in Southern California. Other symptoms include:
Dr. Segura says if you are experiencing these symptoms you must seek medical attention immediately. Your healthcare provider may require further testing because “it’s not always easy to diagnose DVT in pregnancy from symptoms alone,” she says. What problems are associated with blood clots during pregnancy?Blood clots during pregnancy can increase your risk of complications including:
Bleeding during early pregnancySometimes during pregnancy, women pass blood clots vaginally, which is an understandable cause of concern. In the first trimester of pregnancy (first three months), women may bleed as a result of implantation (where the fertilized egg attaches to the uterine wall) or due to early pregnancy loss (miscarriage). Implantation bleeding is usually light and not enough to soak a pantiliner. While not all cases of passing clots within the first 12 weeks of pregnancy are indicative of a loss, vaginal bleeding during pregnancy can be indicative of a complication. For example, bleeding during the first trimester of pregnancy may be caused by a cervical infection, subchorionic hematoma (bleeding from the membranes surrounding the fetus), cervical polyps, ectopic pregnancy, or molar pregnancy (in which a fertilized egg develops into abnormal tissue). That’s why if you experience bleeding of any kind–including blood clots, it’s best to follow up with your obstetrician, gynecologist, or another healthcare professional. Blood clots that develop in the body can increase the risk of miscarriage, or loss of a fetus prior to 20 weeks of pregnancy. Signs of a miscarriage include vaginal spotting or bleeding, abdominal cramping, back pain, and passing fluid, tissue or blood clots from the vagina. Light vaginal bleeding often occurs during the first trimester, but if you are bleeding or passing blood clots or tissue, seek immediate medical attention and bring the discharge to your provider. Bleeding in the second and third trimestersIn the second and third trimesters, bleeding could be caused by a variety of factors. These may include miscarriage, preterm labor, or obstetric abnormalities including placenta previa, or placental abruption. Bleeding and especially passing clots during pregnancy can be a sign of miscarriage, preterm labor, or other complications, so make sure to contact your healthcare provider if you experience bleeding. How to prevent and treat blood clots in pregnancyWhen it comes to DVT in pregnancy, prevention is key. In my own case, I was known to have a higher risk due to a thrombophilic disorder, as well as a history of previous clots. This meant that I was given an injectable low-molecular-weight Heparin (LMWH) drug (Fragmin coupons | Fragmin details) for the duration of my pregnancy as a preventive measure. There are also other preventative measures that can help lower your risk of clots, Dr. Segura says, including:
Although the development of blood clots during pregnancy can be dangerous, they are still fairly uncommon—and treatable. Due to associated risks to you and your developing baby, getting diagnosed and treated as soon as possible is crucial. Anticoagulant medications (also known as blood thinners) can be prescribed to help to break up the clot and get the blood moving again. Dr. Segura says that both Heparin and low-molecular-weight Heparin are safe in pregnancy for mother and baby. The main side effect of taking blood thinners is an increased risk of bleeding, so your doctor will monitor you as the pregnancy progresses. Can there be small chunks in implantation bleeding?Implantation bleeding, however, should not present any clots. Amount. Most women are able to fill pads and tampons during their periods, but with implantation bleeding, it is different. The descriptor “bleeding” can be misleading – implantation bleeding is usually only spotting or a light flow rather than a full flow.
Can a clot come out during implantation?Implantation bleeding looks like light spotting that appears when you wipe. It may also look like a consistent, light flow of blood that needs a light pad or panty liner. The blood may look orange, pink, or brown. There are usually no clots in implantation bleeding in the early stages of pregnancy.
What if implantation bleeding has clots?Although implantation bleeding is not usually a cause for concern, you should talk with a doctor if you experience symptoms like: persistent bleeding. vaginal blood clots or bleeding that saturates a pad every 30 minutes.
|