Blood clot occurs when platelets clump together and the blood thickens due to injury. But it can also happen when abnormal changes within the blood vessel triggers the blood clotting process resulting to thrombus (solid clump of blood) formation inside the vessel. This can cause damage to body organs in severe situations which can lead to death such as in cases of pulmonary embolism. Such clots are most common in the deep vessels of the legs, pelvis and arms. It may also occur in the blood vessels of the placenta during pregnancy.
Being pregnant, the blood clots more easily for the purpose of helping the body get ready to lessen blood loss during labour and birth. Many women even experience passing blood clots during pregnancy. However, presence of vaginal bleeding and blood clots during early pregnancy which happens in about 20-30% of women, about half of them will be at risk of miscarriage.
Blood flow towards the legs gets slower in the later stages of pregnancy. This happens because the blood vessels around the pelvis and surrounding areas are more compressed (narrowed) as the growing uterus (womb) puts increasing pressure on the pelvis. It is common to experience discomfort or swelling in the legs. However, there have been cases of abnormal blood clot in leg during pregnancy. This is a serious medical condition known as Deep Vein Thrombosis. The condition usually happens in one leg only.
Blood Clots During Pregnancy
Most women who display blood clotting situations have healthy pregnancies. But in some women, there exist formation of abnormal blood clot during pregnancy which is considerably found to cause problems. In severe cases, they can cause insufficient blood supply leading to potential death for both the mother and the baby. But regular examinations and immediate medical management can be helpful in saving both the mother and the baby.
Below are some essentials to note regarding blood clots during pregnancy:
1. A blood clot in placental vessel may harm the baby.
Placenta is a connection between the womb and baby. It’s vital for supply of nutrition and oxygen through the umbilical cord. The blood is more likely to clot as a way to work properly during pregnancy. However, the unusual formation of blood clot in placental vessels can break the significant connection with the baby. This can lead to placental insufficiency (due to restricted oxygen supply delivered to the baby), intra uterine growth restriction (IUGR), premature birth, miscarriage or stillbirth.
2. Presence of blood clot in deep veins can harm vital organs.
When a blood clot is present in deep veins, the formation will likely occlude the lumen of the affected blood vessel and block the circulation either partially or completely leading to poor circulation and other related manifestations. With Cerebral Vein Thrombosis (CVT), the person may experience headache, confusion, disturbed vision, seizures and even stroke, whereas in Deep Vein Thrombosis (DVT), the person may display a painful, swollen and discoloured skin with engorged superficial veins of the affected area. Some women develop DVT because along other associated factors, like any other underlying condition, blood flow in the veins is reduced. This can caused by the growing uterus and pregnancy hormones.
3. Wandering blood clots are highly dangerous.
This situation is called Venous Thromboembolism (VTE) and it happens when a formed blood clot breaks off and travels through the blood. It end up in vital organs, like the brain, lungs or heart. This condition is associated with Deep Vein Thrombosis (DVT), Cerebral Vein Thrombosis (CVT) and Pulmonary Embolism (PE). VTEs that block blood vessels in the brain or heart can cause stroke or heart attack.
4. Blood clots present in the heart, brain and lungs can take life away.
This can occur when:
• Heart: An embolism exists. This is a blood clot that has been dislodged from where it was formed and moved to another site in the body. When the clot moves to the heart, it blocks blood and oxygen flow to the heart. Without blood and oxygen, the function of the heart will be impaired. It won’t be able pump blood well and in many cases, the affected heart muscle will die. Heart attacks can lead to a lasting heart damage or death.
• Brain: This happens when a blood clot creates blockage of a blood vessel towards the brain, or when a blood vessel in the brain bursts open due to blockage by a blood clot. The condition is known as stroke. Stroke can cause lasting damage to the brain or even death. Pregnancy and childbirth causes strokes in approximately 8 out of 100,000 women.
• Lung: When the clot moves to the lungs, it can cause pulmonary embolism (PE). PE leads to low oxygen levels in the blood and damage to body organs. This is an emergency situation and one of the leading cause of maternal death during pregnancy in developed countries. If the person is experiencing trouble in breathing, congested chest with pain and coughing out of blood, probably the person may be facing PE.
5. Being pregnant itself increases risk for having blood clots.
Women are most likely to experience a blood clot in their first three months of pregnancy due to sluggish blood flow in the compressed vessels surrounding the pelvis; or the first six weeks after giving birth due to adopted increased blood coagulation tendency significant in overcoming bleeding during the delivery.
6. Risk of getting blood clots increases with the following factors.
• If you had thrombosis (a clot) before
• If you are over 35 years old and pregnant
• Having thrombophilia – abnormality of blood coagulation
• Obesity – with a BMI of 30 or more
• Carrying twins or more
• Having a parent, sister or brother who has had a thrombosis
• Having severe varicose veins – painful or present above the knee with swelling or redness
• Having fertility treatment
• Underwent major surgeries as c-section, appendectomy etc.
• Not moving (being immobile) for long a period, including bed rest after an operation and long-distance travel of more than four hours
• If you are a smoker
7. How does blood clots get diagnosed.
Once your doctor suspects blood clots, he may use tests like Ultrasonography, Magnetic Resonance Imaging (MRI) or VENO graph to detect and locate the blood clot in your vessels. Blood tests may also be needed in order to check the hypercoagulability of your blood.
8. How to assess the health of baby in the womb when at risk of blood clot.
To check the status of the baby in the womb, the doctor may use color Doppler ultrasonography. This is also used to identify the flow of blood from the mother to the baby. The doctor may advise fetal heart rate monitoring to make sure that your baby is getting enough oxygen.
9. How to overcome a blood clot.
If you are pregnant and having clotting conditions or falling under high risk category, you need to have frequent prenatal checkups and care. Your doctor can put you on heparin therapy, like use of low molecular weight heparins or may suggest Vitamin K Antagonist therapy which will be observed until up to six weeks after childbirth.
10. How can I prevent a blood clot from happening.
• Immediately stop smoking if you are a smoker and live a healthy lifestyle.
• Drink plenty of liquids to be hydrated.
• Maintain your body weight and follow healthy diet habits.
• Mild exercise like walking, swimming, etc. on regular basis will improve circulation and helps prevent clotting.
• Wear compression stockings as you travel or anytime you have to stay idle for a long period of time. Compression stockings help blood to circulate more easily and quickly by squeezing the pelvis and limb muscles. You can get compression socks here.
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