Venous Thromboembolism in Pregnancy and Childbirth

A Narrative Awareness On Venous Thromboembolism

Susie had given birth to a beautiful baby girl, an exact replica of her husband with his delicate lips and ebony complexion.

The time came for her to be discharged from the hospital, and her husband couldn't be any happier. It was just a couple of days ago that she was hospitalised due to prolonged labour. He had earlier joked that he would pay her back by taking a week’s rest for subjecting him to vigils that were unsolicited for.

The journey was comforting; he couldn't wait to shower them with endless love. He glanced briefly at her by his side cuddling their baby, and couldn’t help noticing the almost masked wince she made when she drew baby Dee to her bosom. As though she knew he was about asking her what the problem was, she locked her eyes with his and smiled at him reassuringly. It was just a mere chest pain that stopped almost immediately it came.

Or so, she thought.

They got home safely. He led the way into their sparsely but beautifully lighted bedroom. No sooner than baby Dee was laid in her cot by her mother that Susie let out a heart-somersaulting scream as she clutched her two breasts in agony.

She screamed again. And again. Blood dripped down the corner of her mouth as she coughed repeatedly. With what looked like total resignation to fate, she collapsed helplessly on their marbled floor. A noiseless fart escaped her husband's rectum, as he felt urine dripping down heatedly onto his pants.

He couldn’t remember how he got to the hospital with Susie. She was hurriedly carried off into the emergency unit of the hospital they had left a few hours earlier. He also forgot he could sit down as he hovered to any direction medics sailed to.

After what seemed like eternity, he was told, “...Sorry...pulmonary embolism...” He laughed as he felt his reasoning faculty being exchanged with a lunatic’s.

He laughed until he felt himself crying like he was vying for a championship title. He remembered there was a baby in the cot, and the front door to their home left ajar. He cared less. His wife was gone. With his mind's eyes, he could see the devil dancing to an unheard disco while beckoning on him to hell...

Venous Thromboembolism Is A Silent Killer

Susie suffered from a fatal pulmonary embolism as a result of venous thromboembolism, a disease condition that is ten times more common in pregnant women than in non-pregnant women of a similar age (The Royal College of Obstetricians and Gynaecologists, 2009). It is said to be caused as a result of little or no change in the normal flow of blood (venous stasis) and the increased level during pregnancy, of factors that coagulate blood, present in the blood.


Venous Thromboembolism can occur at the vessels of the leg (commonly the left leg), giving rise to Deep Vein Thrombosis or at the vessels of the lungs resulting in Pulmonary Embolism.
Susie was at risk of having venous thromboembolism because she had a prolonged labour and was immobilised in bed for days. Other factors that can predispose a pregnant woman to the condition is a strong family history of thrombosis and haemophilia, trauma and fall, multiple birth (had given birth to twins, triplets, etc., before), maternal age greater or equal to 35 years, gestation (period of pregnancy) less than 36 weeks, sickle cell disease, obesity, pre-eclampsia (a condition that basically causes a pregnant woman's blood pressure to be very high), bleeding, etc.

How does Deep Vein Thrombosis present itself? 

According to Dr Laurence Knott, the presentation could be: left leg pain and discomfort, swelling of the legs that spanned through first to third trimester of pregnancy; increased body temperature and increased white blood count. There may be signs of Pulmonary Embolism.
How does Pulmonary Embolism present itself? Dr Knott suggested: difficult/laboured respiration, mild to severe chest pain, coughing out of blood, faintness, abnormally rapid breathing, collapse. There may be signs of Deep Vein Thrombosis.

Kindly make haste to report to the hospital anytime you have one or more of the above symptoms. Maintain a healthy weight during pregnancy and do not hesitate to move about or engage in mild exercises as recommended by your doctor. No chest pain is ordinary. Pulmonary Embolism can occur suddenly. Know your family history especially on thrombosis and haemophilia, and be willing to report any fall or trauma you must have had in the course of your pregnancy. Visit the hospital from time to time. Be willing to adhere strictly to doctor’s advice.

In managing Venous Thromboembolism, doctors administer heparin in the form of unfractionated heparin or low-molecular weight heparin. This is given to pregnant women at high risk of having the disease condition, all through pregnancy and for four to six weeks after childbirth. This is done after proper diagnosis by doctors.

Not all deaths after childbirth are mysterious. Some could have been as a result of Venous Thromboembolism.