TY - JOUR
T1 - Inferior vena cava filters in pregnancy
T2 - Safe or sorry?
AU - Bistervels, Ingrid M.
AU - Buchmüller, Andrea
AU - Tardy, Bernard
N1 - Funding Information: We thank Daniel Petrov for his critical suggestions and feedback. Publisher Copyright: Copyright © 2022 Bistervels, Buchmüller and Tardy.
PY - 2022/11/7
Y1 - 2022/11/7
N2 - Background: Potential hazards of vena cava filters include migration, tilt, perforation, fracture, and in-filter thrombosis. Due to physiological changes during pregnancy, the incidence of these complications might be different in pregnant women. Aim: To evaluate the use and safety of inferior vena cava filters in both women who had an inferior vena cava filter inserted during pregnancy, and in women who became pregnant with an inferior vena cava filter in situ. Methods: We performed two searches in the literature using the keywords “vena cava filter”, “pregnancy” and “obstetrics”. Results: The literature search on women who had a filter inserted during pregnancy yielded 11 articles compiling data on 199 women. At least one filter complication was reported in 33/177 (19%) women and included in-filter thrombosis (n = 14), tilt (n = 6), migration (n = 5), perforation (n = 2), fracture (n = 3), misplacement (n = 1), air embolism (n = 1) and allergic reaction (n = 1). Two (1%) filter complications led to maternal deaths, of which at least one was directly associated with a filter insertion. Filter retrieval failed in 9/149 (6%) women. The search on women who became pregnant with a filter in situ resulted in data on 21 pregnancies in 14 women, of which one (6%) was complicated by uterine trauma, intraperitoneal hemorrhage and fetal death caused by perforation of the inferior vena cava filter. Conclusion: The risks of filter complications in pregnancy are comparable to the nonpregnant population, but could lead to fetal or maternal death. Therefore, only in limited situations such as extensive thrombosis with a contraindication for anticoagulants, inferior vena filters should be considered in pregnant women.
AB - Background: Potential hazards of vena cava filters include migration, tilt, perforation, fracture, and in-filter thrombosis. Due to physiological changes during pregnancy, the incidence of these complications might be different in pregnant women. Aim: To evaluate the use and safety of inferior vena cava filters in both women who had an inferior vena cava filter inserted during pregnancy, and in women who became pregnant with an inferior vena cava filter in situ. Methods: We performed two searches in the literature using the keywords “vena cava filter”, “pregnancy” and “obstetrics”. Results: The literature search on women who had a filter inserted during pregnancy yielded 11 articles compiling data on 199 women. At least one filter complication was reported in 33/177 (19%) women and included in-filter thrombosis (n = 14), tilt (n = 6), migration (n = 5), perforation (n = 2), fracture (n = 3), misplacement (n = 1), air embolism (n = 1) and allergic reaction (n = 1). Two (1%) filter complications led to maternal deaths, of which at least one was directly associated with a filter insertion. Filter retrieval failed in 9/149 (6%) women. The search on women who became pregnant with a filter in situ resulted in data on 21 pregnancies in 14 women, of which one (6%) was complicated by uterine trauma, intraperitoneal hemorrhage and fetal death caused by perforation of the inferior vena cava filter. Conclusion: The risks of filter complications in pregnancy are comparable to the nonpregnant population, but could lead to fetal or maternal death. Therefore, only in limited situations such as extensive thrombosis with a contraindication for anticoagulants, inferior vena filters should be considered in pregnant women.
KW - anticoagulants
KW - pregnancy
KW - safety
KW - vena cava filter
KW - venous thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=85142257452&partnerID=8YFLogxK
U2 - https://doi.org/10.3389/fcvm.2022.1026002
DO - https://doi.org/10.3389/fcvm.2022.1026002
M3 - Article
C2 - 36419489
SN - 2297-055X
VL - 9
JO - Frontiers in cardiovascular medicine
JF - Frontiers in cardiovascular medicine
M1 - 1026002
ER -