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Thromboembolism in Pregnancy: A Continuing Conundrum

Richard V. Lee, MD
[+] Article, Author, and Disclosure Information

From the State University of New York at Buffalo, Buffalo, NY 14214.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Richard V. Lee, MD, 7664 East Quaker Road, Orchard Park, NY 14127; e-mail, dmdrvl@buffalo.edu.

Ann Intern Med. 2005;143(10):749-750. doi:10.7326/0003-4819-143-10-200511150-00013
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Clinicians have known for years that pregnancy places women at increased risk for thromboembolism. In 1878, Angus MacDonald described pulmonary embolism and infarction in postmortem examinations of women dying during pregnancy and the postpartum period (1). He commented on the frequency of embolic events in women with cardiovascular disease who died. Our understanding of the pathophysiology and the natural history of thromboembolic disease in pregnant and postpartum patients has been expanding ever since 1856, when Virchow (2) postulated that hypercoagulability, vessel wall injury, and alterations in blood flow foster thrombus formation.

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