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The incidence o f deep vein thrombosi s in pregnancy and
the puerperium is r eported to be fiv e to six t i mes higher t han
that i n the non-pregnant non-contraceptI v e -pill tak i ng femal e
( 12 9] . In the United States, fo r example, 50\ of all t hrombo ­
embolic e ve nts In fe males less than 40 years were said to be
re lated to pregnancy and t he puerpe riull {130].
The majority ot t hrombotic e p i s ode s however , occur during
the early postpa rtum period {lJl,13 2 ]. For ex amp le, 85 \ ot' t he
357 ca ses o f thrombophl e bi tis s tudied by Aare et aI, occurred
in t he po s t pa r t um period up to 24 days [1 32] . I n Eng land end
Wales, it was ob serv ed that two -thirds of pufncnary eaboLf s m
episodes i n vo ue n from 1 9 7 9-8 1 oc curred postnatally [ 131]. The
incidence of an tepartum and postpartum deep ve in thrombosis
was reported t o be 0 . 1 3 and 0 . 61 per 10 00 respect ively in
8o r a s , Sweden from 19 75-80 {133]. Another retrospecti ve study
o ve r a 28 year period in the Netherlands r eported rates of
thrombosis and pulllonary embolism t o be 0. 7\ i n pregnancy and
2.3 \ i n the puerperfun [ 13 4 ] .
Th rombosis ma y be c lassified by whether i t is a s s oc i a.t ed
with a n i nfective process (t h r ombo ph l e b i t i s ) o r not (p h l e bo­
t h rombosis) {4 J ]. I n practice howe ve r , diagnosing thrombosis
i tself i s oft en d ift'1cu l t, let a lone distinguishing be tween
t he two type s o f co nd i t ions. Hany articles and reports o n
puerper a l thrombos i s have not a t t e mpt e d to separate the s e two
condit ions {lJ2-137]. In t his discuss ion therefore , even