[Venous thromboembolism during pregnancy].

Pulmonary embolism is one of the most common cause of maternal death in developed countries. Pregnancy is associated with a hypercoagulable state, increased especially in patients with thrombophilia. The post-partum period is the period carrying the highest risk of venous thromboembolism, especially after caesarean delivery. The diagnosis is essential, applying strategies validated in the non-pregnant population, as none of the diagnostic tests is contra-indicated during pregnancy. These strategies use a combination of empirical evaluation of clinical probability, D-Dimer measurement. In case of positive D-Dimer testing (or high clinical probability), ultrasonography of the legs should be performed first; if there is no proximal deep vein thrombosis, pulmonary CT scan or lung scan should be performed. Low molecular weight heparin is the treatment of choice until 6 weeks after the delivery, for a minimal total duration of 6 months. The prophylaxis must be individually decided according to histories and risk factors of the patient.