DVT in postpartum period

Venous thromboembolic risk in postpartum - Servier

Postpartum is the highest risk period Historically, the last trimester and immediate postpartum were considered the highest risk periods for deep vein thrombosis (DVT) and pulmonary embolism (PE). However, more recent studies have shed further light on these data The most common symptoms of deep vein thrombosis during pregnancy and postpartum usually occur in just one leg and include: A heavy or painful feeling in the leg (a lot of people say that it feels like a really bad pulled muscle that doesn't go away) Tenderness, warmth and/or redness in the calf or thigh Slight to severe swellin

Although lower-extremity edema is common in pregnancy and the immediate postpartum period, it is usually symmetric. If edema is asymmetric or associated with pain, warmth, redness, or a cord, this.. For admissions resulting in delivery at UW Medical Center, the average postpartum length of stay after cesarean delivery was 2.7 days for the time period August 2017 - July 2019. Average antepartum stay prior to cesarean delivery was 2.4 days, making average total length of stay for cesarean delivery patients 5.1 days The risk of developing blood clots (thrombophlebitis) is increased for about 6 to 8 weeks after delivery (see Thromboembolic Disorders During Pregnancy). Typically, blood clots occur in the deep veins of the legs or pelvis (a disorder called deep vein thrombosis) Risk for postpartum venous thromboembolism is highest during the first 3 weeks after delivery. Women with obstetric complications are at highest risk for postpartum venous thromboembolism, and this risk remains elevated throughout the first 12 weeks after delivery

period for patients with iliac vein VTE to reduce the risk of PE or in patients with proven DVT and Postpartum warfarin should be avoided until at least the fifth day and for longer in women at The subjective clinical assessment of deep venous thrombosis (DVT) and pulmonary embolism (PE) is 'pregnancy'. B. the in pregnancy However, venous thrombosis is still uncommon in pregnancy or in the first 6 weeks after birth, occurring in only 1-2 in 1000 women. A DVT can occur at any time during your pregnancy, including the first 3 months Pregnancy and the puerperium are well-established risk factors for deep vein thrombosis (DVT) and pulmonary embolism (PE), which are collectively referred to as venous thromboembolic disease (VTE) In general, women have bilateral leg edema developed at the third trimester, even lasting to the postpartum period, thus masking the signs of DVT over the legs. In addition, bed rest and hormonal therapy during pregnancy are often prescribed for symptomatic relief, and these management methods may increase the risk of DVT Treatment should continue for a minimum duration of six months, and until at least six weeks postpartum. Induction of labour or planned caesarean section maybe required to allow an appropriate transition to unfractionated heparin to avoid delivery in women in therapeutic doses of anticoagulation. © 2011 The Authors

Thrombosis during pregnancy and the postpartum period. Am J Obstet Gynecol. 2005; 193: 216-219. Crossref Medline Google Scholar; 8 Ray JG, Chan WS. Deep vein thrombosis during pregnancy and the puerperium: a meta-analysis of the period of risk and the leg of presentation. Obstet Gynecol Surv. 1999; 54: 265-271. Crossref Medline Google Schola DVT/PE Prophylaxis Orders: POST CESAREAN DELIVERY Risk Criteria Orders sk All patients without history of VTE, high risk thrombophilia or current anticoagulant use and not meeting moderate risk criteria (below) oFor Cesarean delivery, knee-length Sequential Compression Device, per protocol, until fully ambulator Deep vein thrombosis (DVT) is the formation of blood clots (thrombi) in the deep veins. The highest incidence in childhood is during the neonatal period, the documented rate was 48 DVT per 100,000 births per year. 11 The incidence appears to be highest in the postpartum period. 11, 12. As compared with the absolute increase in risk during the period within 6 weeks after delivery (22.1 cases per 100,000 deliveries), the absolute increase during the postpartum period of 7 to 12.

The risk for venous thromboembolism is higher in the postpartum period, right after a woman has given birth, is two to five times greater. During pregnancy, factors that increase the risk of DVT and venous thromboembolism include deep vein thrombosis. Symptoms of a systemic blood clot in the postpartum period include: chest pain or pressure. loss of balance. pain or numbness only on one side. sudden loss of strength on one. DVT, deep venous thrombosis; PE, pulmonary embolism; VTE, venous thromboembolic event. a Age during the last delivery. We observed the association between selected chronic diseases, pregnancy-related conditions, and delivery complications and the occurrence of postpartum VTE (Tables 3 and 4 ) Between 1966 and 1996, there were 105 cases of venous thromboembolism, including 32 cases of DVT during pregnancy and 44 during the postpartum period (defined as 3 months post-delivery). 17 The incidence of DVT remained relatively constant during pregnancy, but decreased in the postpartum period When blood clots form in the deep veins of the legs, thighs, or pelvis, the signs and symptoms include swelling, pain, warmth, and redness in the affected leg. Pregnancy is a risk factor for the development of deep vein thrombosis. The risk for DVT increases in the postpartum period. Factors that increase the risk of developing DVT in the.

Pregnancy-related DVT comes under scrutiny in France

Deep Vein Thrombosis (DVT) in Pregnancy and Postpartum

  1. The risk in the immediate postpartum period is particularly high. Venous embolism is an important cause of maternal illness and death ( 7 ). CTA or ultrasonography for deep vein thrombosis may be important for COVID-19-positive pregnant or postpartum patients who have signs or symptoms of possible venous embolism, given their potentially.
  2. We describe the case of a 35-year-old postpartum woman who presented to the emergency department with a diagnosis of a new multiple segmental PE 5 days after starting rivaroxaban therapy for a diagnosis of DVT. No precipitating cause, including noncompliance, was identified as a source of thrombosis embolization or extension
  3. Treatment for Postpartum Blood Clots and Bleeding. Most of the women prefer to wear large sanitary pads to collect the postpartum blood. There are pads available with a special cooling material that helps in reducing the postpartum swelling. If the bleeding is excessive and continuous then the woman should visit a doctor
  4. Deep vein thrombosis during pregnancy and the puerperium: a meta-analysis of the period of risk and the leg of presentation. Obstet Gynecol Surv . 1999 Apr. 54(4):265-71. [Medline]
  5. Incidence of VTE in pregnancy and postpartum is 1.72 per 1000 Risk significantly elevated in the 6 weeks postpartum Risk of DVT equal in 1st and 2nd trimesters, higher risk in 3rd trimester and 3 weeks postpartum PE most commonly occurs in postpartum
DVT or Deep Vein Thrombosis:Causes|Symptoms|Treatment

Diagnosis of DVT in the Postpartum Patien

  1. Feb 22, 2013 · Many of the signs and symptoms of DVT overlap those of a normal pregnancy the postpartum period than during pregnancy [3] and postpartum Abstract · Introduction · Case report · Discussio
  2. The postpartum (or postnatal) period begins immediately after childbirth as the mother's body, including hormone levels and uterus size, returns to a non-pregnant state. The terms puerperium, puerperal period, or immediate postpartum period are commonly used to refer to the first six weeks following childbirth
  3. Objective: The objective of this study is to elucidate circumstances surrounding postpartum patients with lower extremity deep vein thrombosis (DVT) including demographics, risk factors, comorbidities, clinical presentation, and outcomes presenting to our tertiary care center.Introduction: Postpartum is a period of increased risk of venous thromboembolism (VTE)
  4. Symptoms of Postpartum Blood Clots. A fever that develops after delivery may be caused by a blood clot. When a blood clot forms in a leg vein, the affected part of the leg, often the calf, may be painful, tender to the touch, warm, and swollen. A blood clot in the pelvis may not cause symptoms. The first sign of pulmonary embolism may be.
  5. DVT: unilateral leg pain, swelling in extremity, increase in calf circumference (more than 2 cm), increased • Increased risk of VTE postpartum • Signs/symptoms of VTE and seeking help • Importance of correct use, application and duration of prophylaxis • Implications for future pregnancy

Venous thromboembolism was defined as deep vein thrombosis (DVT), pulmonary embolus (PE), or both. When both were present, and the record was assigned to 1 category, the record was assigned to PE. ICD-9 codes used for deep vein thrombosis included the pregnancy-related codes 671.3, 671.4, and 671.5 and the standard codes, 451-453 What are the risk factors for deep vein thrombosis? During pregnancy and the postpartum period, women are 5 times more likely to deep vein thrombosis. The risk per day is the highest in the postpartum period, and even higher when certain risk factors are present. Risk factors include: Personal history of VTE; Presence of thrombophilia; Cesarean. If extensive iliofemoral DVT is diagnosed late in the third trimester, placement of an IVC filter may be considered along with anticoagulation, followed by PDCT as soon as deemed safe after delivery. PDCT could be considered in the postpartum period for patients with iliofemoral DVT, as these are young and usually otherwise healthy women

  1. DVT, deep venous thrombosis; PE, pulmonary embolism; VTE, venous thromboembolic event. a Age during the last delivery. We observed the association between selected chronic diseases, pregnancy-related conditions, and delivery complications and the occurrence of postpartum VTE (Tables 3 and 4 )
  2. If DVT or pulmonary embolism is suspected postpartum, the doctor will suggest a few diagnostic tests before prescribing the ideal course of treatment . Diagnosis. D-dimer test: In the case of a suspected deep vein thrombosis, ultrasonography is done. Then, a blood test is carried out to detect the amount of D-dimer, which is a substance.
  3. The postpartum period, defined as the 12 weeks after delivery, is an important time for a new mother and her family and can be considered a fourth trimester. Outpatient postpartum care should be.
  4. Page 1 of 5 Rate and Risk Profile of Deep Venous Thrombosis in Pregnancy and Postpartum Period Among Sudanese Women Awadalla Mohammed Abdelwahid1, Samia Elhaj Elawad Abd Alla2, Hajar Suliman Ibrahim Ahmed3, Omer Mohamed Ali Mandar4 and Siddig Omer M Handady5* 1Assistant professor of Obstetrics and Gynecology, Faculty of Medicine, Al Neelain University, Suda
  5. The highest risk of blood clots among reproductive-aged women occurs during pregnancy and in the postpartum period, when estrogen levels increase. Among pregnant women, between 5 and 20 in every 10,000 pregnant women will experience a blood clot in a year; 40 to 65 in every 10,000 postpartum women experience a blood clot in a year
  6. Diagnosis of DVT is usually by Doppler ultrasonography. In the postpartum period, if Doppler ultrasonography and plethysmography are normal but iliac, ovarian, or other pelvic venous thrombosis is suspected, CT with contrast is used
  7. knowing the signs and symptoms of a blood clot listed above Postpartum hemorrhage or excessive bleeding Continued bleeding can lead to severe, life-threatening blood loss

Postpartum Blood Clots - Women's Health Issues - Merck

To describe the circumstances surrounding deep vein thrombosis among pregnant or postpartum patients enrolled in a large multicenter registry. Study design Consecutive patients with ultrasound-confirmed deep vein thrombosis were enrolled at 183 institutions during a 6-month period from October 2001 to March 2002 The incidence was high, especially in the third trimester and the first week of the postpartum period, with a relative risk for DVT postpartum vs during pregnancy being 4.12 (95% CI, 2.62-6.50; P<0.001). The relative risk of venous thromboembolism was 4-times higher for pregnant woman than for nonpregnant women of the same age

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Postpartum Venous Thromboembolism: Incidence and Risk

  1. Venous thromboembolism is an important cause for maternal morbidity and mortality in postpartum period. Though catheter-directed thrombolysis (CDT) is now considered as a safe and effective therapy for the management of deep venous thrombosis (DVT) but still it is not indicated in postpartum DVT. We are presenting a case of 22-year-old female patient who presented with post-partum lower limb.
  2. e blood clotting during the pregnancy and postpartum period in healthy women and those with inherited thrombophilia disorders, outlining evidence-based prevention strategies, thromboprophylaxis, and treatment to enhance APRN practice and improve maternal and fetal outcomes
  3. The area of the blood clot will be swollen and red due to the pressure created by the blood clot on the vein. This pressure builds up and affects the surrounding tissues. You may also feel numbness and warmth in the swollen area. 5. Coughing. A blood clot which has moved up to the lungs can cause severe coughing resulting in pinkish sputum
  4. During the postpartum period, blood clots are 20 times more likely when compared to non-pregnant women, according to a 2009 review published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology

Treatment of venous thrombosis in pregnancy and after

INTRODUCTION. Pregnancy and the puerperium (postpartum period) are well-established risk factors for venous thromboembolism (VTE), which occurs with a prevalence of 1 in 1600 [].The overlap with symptoms of pregnancy may impair clinical suspicion making diagnosis of VTE more challenging May-Thurner syndrome (MTS), also known as iliac vein compression syndrome, is one of the least recognized causes of deep venous thrombosis (DVT) in reproductive-aged women. First reported by May and Thurner1 in 1957, this anatomic variant involves compression of the thin-walled left common iliac vein by the thick-walled overriding right common iliac artery, resulting in intraluminal collagen. Pregnancy increases the risk of venous thromboembolism (VTE) 4- to 5-fold over that in the nonpregnant state. [1, 2] The two manifestations of VTE are deep venous thrombosis (DVT) and pulmonary embolus (PE).Although most reports suggest that VTE can occur at any trimester in pregnancy, studies suggest that VTE is more common during the first half of pregnancy (see the image below) Deep vein thrombosis. Dr Daniel MacManus and Assoc Prof Frank Gaillard et al. Deep vein thrombosis (DVT) most commonly occurs in the lower limbs, however, are not uncommon in the upper limb and neck veins. Other types of venous thrombosis, such as intra-abdominal and intracranial, are discussed in separate articles -can occur in any trimester of pregnancy and in the postpartum period. -DVT occurs most often during pregnancy, and PE is more common in the postpartum period -VTE in the postpartum period has declined since early ambulation after childbirth has become standard practice. -PE is the major cause of maternal death

During the postpartum period, roughly the six weeks following giving birth, women can be affected both by bleeding disorders and blood clotting.Also known as post-partum hemorrhage, the term post-partum bleeding generally refers to excessive bleeding during the first day after birth, but serious bleeding also can occur during the several weeks following delivery In the first few days following childbirth, the risk of DVT is relatively high as hypercoagulability increases during pregnancy and is maximal in the postpartum period, particularly for women with C-section with reduced mobility. Anti-coagulants or physical methods such as compression may be used in the hospital, particularly if the woman has risk factors, such as obesity, prolonged immobility.

Stop the Clot, Spread the Word ®. The National Blood Clot Alliance and the Centers for Disease Control and Prevention are working on this important public health campaign to get the word out about blood clot risks and the signs and symptoms of blood clots. You can be an important part of this education campaign by helping us In one cohort of pregnant women with inherited thrombophilia, 7/50 (14%; 95% CI 8-28%) AT deficient women developed deep vein thrombosis (DVT) during pregnancy compared to 0.2% in the general population . This risk was shown to be higher in the postpartum period (11/39 28%; 95% CI 30-36%) Pregnancy and peripartum increase the risk of venous thromboembolism (VTE) by many folds. Interestingly, the VTE is more common during the pregnancy, whereas the pulmonary embolism is more frequent in postpartum period. There are various risk factors for the VTE and pulmonary embolism in these patients. The important risks are improper thromboprophylaxis, obesity, and multigravida Deep vein thrombosis (DVT) is the development of a blood clot within a vein deep to the muscular tissue planes. DVT most commonly affects the legs, but can also affect the arms, and other sites in the body. The incidence of DVT during pregnancy or the postpartum period is approximately 1 case per 1000 live births

The Psychological Impact of DVT and PE Beth Waldron, MA. The evaluation of the care and outcome of patients with venous thromboembolism is often focused on the visible short-term effects of a clot, such as: Has the acute clotting episode resolved? Are chronic pain, swelling, or other post-thrombotic issues well managed The observed increase in thrombosis risk among postpartum women agrees with the existing literature; a meta-analysis conducted to contrast the risk among these two groups estimated that the relative risk among 100 DVT events was 0.23 per day during pregnancy, against 0.83 per day during the postpartum period


Postpartum deep vein thrombosis resolved by catheter

Chapter16 nursing management during the postpartum period.pdf - Case Studies Chapter 16 Nursing Management During the Postpartum Period 1 You are caring. (DVT) is a blood clot that forms in a vein deep in the body, usually in the leg. Several factors such as reduced mobility, obesity, surgery (cesarean section),. Venous thromboembolism (VTE), also known as blood clots, includes blood clots in a deep vein such as in the arm or leg (deep vein thrombosis or DVT) and a blockage in the lungs known as a pulmonary embolism (PE). Pregnant women are at increased risk (likelihood) for a VTE due to the natural changes that occur in a woman's body in preparation for childbirth Chapter 16: Nursing Management During the Postpartum Period 1. You are caring for Bonnie, age 42, who has just undergone a cesarean birth for her first baby. You are responsible for monitoring her condition during recovery and for teaching her how to take care of herself and her baby

Deep vein thrombosis (DVT) and venous thromboembolism (VTE) are major health problems with high mortality and morbidity in pregnancy and postpartum period worldwide. 1 The high incidence of DVT and risk of VTE during pregnancy and postpartum period occurs due to hypercoagulable state. 2 Catheter-directed thrombolysis (CDT) is a safe and effective in management of symptomatic DVT by lysing the. Deep vein thrombosis (dvt) 1. By- Dr. Armaan Singh paresis Malignancy Cancer therapy Previous DVT Increasing age Pregnancy and the postpartum period Estrogen-containing oral contraceptives or hormone replacement therapy Selective estrogen receptor modulators Acute medical illness Heart or respiratory failure Inflammatory bowel disease. Deep vein thrombosis (DVT) is the development of a blood clot within a vein deep to the muscular tissue planes. DVT most commonly affects the legs, but can also affect the arms, and other sites in the body. The incidence of DVT during pregnancy or the postpartum period is approximately 1 case per 1000 live births. James AH. Pregnancy. 10 code (used in Finland from year 1996) of deep venous thrombosis (DVT) (I80.1-I80.9), portal vein thrombosis (I82.0-I82.9), pulmonary embolism (PE) (I26.0, I26.9) and VTE specifically related to postpartum or delivery (O87.1 and O88.2) were included. Each woman with a VTE diagnosis is included in only one group, either DVT

Recommendations for the diagnosis and treatment of deep

Pelvic vein thromboses, which account for less than 1% of all cases of DVT confirmed by venous ultrasound, 18 are rare outside of pregnancy or pelvic surgery, yet account for approximately 10% to 12% of DVT during pregnancy and the postpartum period. 8 Two percent of pregnancy-associated DVT occurs in the upper extremity, 8 but the cases of DVT. The majority of pregnancy‐associated deep venous thrombosis cases occurred in the left leg. During pregnancy 85% of women (23 out of 27) had a left‐sided deep venous thrombosis, compared with 68% (32 out of 47) of women in the postpartum period Symptomatic pregnancy associated venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is estimated to occur antepartum (from conception to delivery, ie, ∼40 weeks) in 5-12 per 10 000 pregnancies and to occur postpartum (6 weeks) in 3-7 per 10 000 deliveries. 1 VTE remains a leading cause of direct maternal death in the developed world, causing 0.8. pregnancy or the postpartum period, such as those with Suspect lower extremity deep vein thrombosis Compression ultrasonography of lower extremity or extremities Results Negative or equivocal and suspect iliac vessel process Additional imaging studies Presumptive anticoagulation therapy Results Routine surveillance Treat Fig. 1 Venous thromboembolism (VTE) is a term used to describe blood clots that develop in the veins, such as a deep vein thrombosis (DVT) of the deep leg veins, or a blood clot that has traveled to the lungs called a pulmonary embolism (PE). 1 Pregnancy increases the chance of developing VTE by about four- to fivefold. 2 The chances are even higher immediately after childbirth

Venous Thromboembolism in Pregnancy Arteriosclerosis


The 2021 edition of ICD-10-CM O87.1 became effective on October 1, 2020. This is the American ICD-10-CM version of O87.1 - other international versions of ICD-10 O87.1 may differ. O87.1 is applicable to maternity patients aged 12 - 55 years inclusive. Certain conditions have both an underlying etiology and multiple body system manifestations. In a 30-year population-based study, Heit et al. documented that the risk of VTE and PE was 5-fold and 15-fold, respectively, in the postpartum period compared to during pregnancy. DVT is approximately three times more common that PE in pregnancy. In pregnancy, DVT is much more likely to occur in the left leg compared with the right leg Superficial thrombophlebitis is commonly prevalent during the postpartum period than during pregnancy and is seen more in women experiencing varices. Postpartum deep vein thrombosis (DVT) and superficial thrombophlebitis have been attributed to trauma to pelvic veins from the pressure exerted by the presenting fetal part, impaired circulation caused by mechanical edema, and changes in. Post means after, and partum means pregnancy, so postpartum refers to the time period after you have a baby. It's usually considered the first 6 weeks. It's usually considered the first 6 weeks. A blood clot (called a thrombus) sometimes forms inside a blood vessel In most cases, a stringy or gel-like consistency is just a blood clot leaving your uterus. Blood clots that are small (about the size of a quarter) are normal. Remember that your period.

Deep vein thrombosis: a clinical revie

Risk of a Thrombotic Event after the 6-Week Postpartum Perio

The risk for DVT increases in the postpartum period. Factors that increase the risk of developing DVT in the postpartum period include: Cesarean section; Stillbirth; High blood pressure (hypertension) Eclampsia or preeclampsia; Postpartum infection; Obstetric hemorrhage; Preterm delivery at less than 36 weeks; Other underlying medical condition Deep vein thrombosis (DVT) is a condition in which a blood clot (thrombus) forms in one or more of the deep veins, usually in the legs. Blood clots can break free and travel with blood causing life-threatening condition like pulmonary embolism (PE) or a stroke due to paradoxical embolism in people with patent foramen ovale (PFO) They also found in studies that the VTE risk is increased during pregnancy and the postpartum period, and that the risk is most pronounced for women in the first 3 weeks after delivery, and it decreases to near baseline levels by 42 days postpartum (US Medical Eligibility Criteria for Contraceptive Use 2018)

DVT during Pregnancy Symptoms, Causes, Treatment & Risk

half during the 6-week postpartum period. As a result, the daily absolute risk is highest during the postpartum period, as the antepartum period lasts much longer than the postpartum period.7,8 The diagnostic management of DVT and PE in pregnancy is challenging due to the fact that preg-nant women often have clinical symptoms of th If DVT or PE is suspected in the postpartum period, the patient should be investigated as in non-pregnant patients, remembering that the pretest probability will be higher as this is the highest risk time for VTE in pregnant patients. CT scan is safe in breastfeeding; however, radioisotopes used i With the advent of contrast venography as a means of objectively diagnosing DVT, it became evident that symptoms and clinical signs were extremely inaccurate for the diagnosis of DVT. 1 Studies during the last 30 years have shown that among symptomatic patients with suspected DVT referred by clinicians for diagnostic testing, the diagnosis is. Using these figures, the estimated relative distribution of 100 deep vein thrombosis events during pregnancy and the puerperium would be 0.23 per day during pregnancy, and 0.82 per day in the postpartum period. During pregnancy and the puerperium, deep vein thrombosis is more likely to arise in the left leg

Blood Clots After Birth: Symptoms, Treatment, and Mor

Compared with in women assessed as high-risk or those in the postpartum period, missed opportunities by implementing of mechanical methods were more prevalent in women assessed as low risk; compared to DVT cases, the lack of early mobilization was much more prominent among the PTE cases In the postpartum period specifically, women following CS exhibit greater activation of coagulation than women following VD, as reflected by greater D-dimer levels, explained Dr. Blondon. D-dimer levels indicate that blood clots may be forming or breaking down in the body

Gene Predictis Gene PredictisPeripartum pulmonary embolism: Anesthetic and surgicalCase ivc filter in pregnancy

Even more important is the immediate postpartum period, during which the incidences of superficial thrombophlebitis and DVT increase to 1.18% and 0.15%, respectively. A Dutch study of pregnant women with age-matched controls found a 5-fold increased risk of venous thrombosis during pregnancy Pregnant and postpartum women 16 years of age and older with suspected PE or diagnosed DVT. Suspected PE defined as the treating clinician determining that imaging for PE would be required. Length of postpartum period was not defined. Exclusion: Women requiring life support on arrival to hospital. Previous PE diagnosed during current pregnancy. exacerbated during pregnancy as seen in this case. One study estimates the relative risk of DVT is increased fivefold during pregnancy and up to twenty times during the postpartum period [3]. In the US, VTE is one of the leading causes of maternal mortality, accounting for 9.3% of all deaths [4]. Risk factor The development of post-thrombotic syndrome (PTS) after iliofemoral deep vein thrombosis (DVT) continues to be a considerable issue for both pregnant and postpartum women with rates as high as 70% among those managed with anticoagulation alone. This study aims to characterize the outcomes of interventional treatment for acute iliofemoral DVT in this at-risk population