Reducing the risk of clots during pregnancy

By Nosa Iyamu

Having a baby is a special time in a woman’s life, a period that is meant to be filled with excitement and delight. However, bringing new life into the world is a delicate process and a level of caution is required to avert pregnancy-related conditions that can risk the lives of the expectant mother and her unborn baby.

Shockingly, Nigeria is one of the countries with the highest maternal mortality rates in the world, accounting for nearly 20 percent of all global maternal deaths. According to the World Health Organisation (WHO), the risk of dying during pregnancy, childbirth, or postpartum for a Nigerian woman is 1 in 22, compared to 1 in 4 900 in developed countries.

There are various factors that put pregnant women at risk for maternal deaths, with blood clotting – also referred to as venous thromboembolism, or VTE – one of the leading causes.

 “Expectant women are at risk of experiencing blood clots during the pregnancy, at childbirth, or up to three months after delivering their baby,” says Dr Helen Okoye, medical expert and spokesperson for the World Thrombosis Day (WTD) campaign. “And, while anyone can develop blood clots, they should be aware of the risks that are associated with this condition during pregnancy.”

Why does pregnancy pose a higher risk?

According to the Centers for Disease Control and Prevention (CDC), pregnant women are five times more likely to experience blood clots compared to women who are not pregnant. There are various reasons for this. During pregnancy, a woman’s estrogen levels are higher than normal, which increases the chance of developing a clot, and a pregnant woman’s blood contains higher levels of clotting proteins and lower levels of anti-clotting proteins

 – which is the body’s way of safeguarding against too much blood loss during childbirth. 

Other clotting risk factors include the fact that blood vessels around the pelvis area are pressed upon by the growing baby, resulting in less blood flowing to the legs. This is a common phenomenon at the midpoint of a pregnancy, says Dr Okoye.

“Another key issue is restricted movement towards the end of the pregnancy, or if the mother has to undergo bed rest after delivery, especially if she has had a C-section. A C-section is a surgery that could cause some damage to blood vessels, thereby increasing the risk of a blood clot,” she advises. 

Know your medical history

If a pregnant woman has a personal or family history of blood clots or a blood clotting disorder, or any long-term medical condition such as hypertension, lupus, sickle cell disease, diabetes, or lung and heart-related ailments, she must highlight it with her doctor or midwife at the onset of the pregnancy, cautions Dr Okoye.

“Expectant women and new moms should do regular visits to their antenatal and postnatal clinic and be as open as possible with their obstetrician/gynecologist or midwife up until a few weeks after delivery. Raise any medical concerns – this way, the medical team will be able to address possible threats and reduce the risk of clotting. This is especially relevant for first-time moms, who may not know what to look out for.” 

Be aware of these signs

The WTD campaign highlights the following warning signs:

A blood clot that forms in a deep vein, usually the leg, groin, or arm, is called deep vein thrombosis (DVT). Signs to look out for include pain or tenderness, often starting in the calf, swelling on the ankle or thigh or the affected limb, redness or noticeable discoloration, and warmth around the affected area.

If part of that clot breaks free and travels to the lungs, it can block blood supply and cause a pulmonary embolism (PE), which may be fatal. Signs of a PE include unexplained shortness of breath, rapid breathing, chest pain (which may be worse upon deep breaths), rapid heart rate, and light-headedness or passing out.

If a diagnosis is made, make sure you adhere to the recommendations and medications prescribed by the doctors to keep the situation under control.

Gain peace of mind

A mother-to-be must do everything possible to ensure that she has a safe and healthy pregnancy, delivery, and recovery period. Throughout this time, don’t be afraid to raise things that are bothering you, with your doctor. Before you go to a medical appointment, write down a list of any concerns that you have, and take the list with you. 

“It’s easy to get so caught up in what is going on during a medical check-up that you could forget to address pertinent issues,” says Dr Okoye. “Don’t be afraid to speak up about things that are bothering you. Even if it seems like a small issue, it’s important that you have peace of mind, and stay safe, during your pregnancy,” she concludes.

In addition to medical care, there are several activities and exercises that can be done while pregnant to promote body fitness and mental wellness. For instance, take brisk walks in your neighbourhood or engage in a well-structured fitness plan designed by a qualified fitness instructor in consultation with your doctor, to keep you fit, healthy and feeling upbeat.

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