In the US and Western Europe, the leading cause of maternal death is thromboembolic disease-excessive clotting and the concomitant obstruction of blood flow and blood vessels. In pregnancy approximately 80% of thromboembolisms are venous; about 20% are arterial (AH James, 2009). Pregnancy and the postpartum period, up to six weeks after delivery, increase women's risk of venous thromboembolism (VTE) 4- to 5-fold. If a woman has thrombophilia, the genetic propensity to develop blood clots, her risk is substantially heightened (ibid.). It is estimated that 5-8 % of the US population has a clotting disorder, thrombophilia (March of Dimes, 2009). Thrombophilia has been found in 20 to 50% of women who experience VTE during pregnancy and the postpartum period (AH James, 2009).
Individuals with thrombophilia experience other pregnancy complications including repeated miscarriage, stillbirth or placental abruption, a condition in which the placenta peels away from the uterine wall before delivery which can cause heavy bleeding that is dangerous for mother and baby (March of Dimes, 2009).
Additionally, women with thrombophilia taking birth control pills or post-menopausal hormone replacement therapy can face complications. About one in 3,000 women per year who take these medicines develop a blood clot. For a woman with thrombophilia the risk becomes much greater (National Blood Clot Alliance, 2010). With counsel from an educated physician who understands blood disorders, blood clots can be reduced by using anticoagulants and/or the appropriate prescribed contraceptives based upon the individual's history of thrombosis.
Diagnostic testing and treatments are readily available for thrombophilia. However, not all cases of thrombophilia and risk factors for VTEs are always identified. More training, education, laboratory studies and epidemiologic research are required to promote optimal prevention and treatment for females with thrombophilia or a history of thrombosis (AH James, 2009), which increase their risk for VTE in pregnancy and the postpartum period.