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Postpartum Blood Clots

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by Julie S. Moldenhauer, MD

The risk of developing blood clots (thrombophlebitis) is increased after delivery. Typically, blood clots occur in the legs or pelvis (a disorder called deep vein thrombosis—see Deep Vein Thrombosis (DVT)). Sometimes one of these clots breaks loose and travels through the bloodstream into the lungs, where it lodges in a blood vessel in the lung, blocking blood flow. This blockage is called pulmonary embolism (see Pulmonary Embolism (PE)).

Symptoms

A fever that develops after delivery may be caused by a blood clot. The affected part of the leg, often the calf, may be painful, tender to the touch, warm, and swollen. The first sign of pulmonary embolism may be shortness of breath.

Diagnosis

Diagnosis of deep vein thrombosis is usually based on results of ultrasonography. Occasionally, a blood test to measure D -dimer (a substance released from blood clots) is helpful. Diagnosis of pulmonary embolism is usually based on computed tomography (CT) of the chest.

Treatment

Treatment of a superficial blood clot in the leg consists of warm compresses (to reduce discomfort), compression bandages applied by a doctor or nurse, and bed rest with the leg elevated (by raising the foot of the bed 6 inches). Women with deep vein thrombosis or pulmonary embolism need to take drugs that make blood less likely to clot (anticoagulants).