We speak of phlebitis, or venous thrombosis, whena blood clotcalled thrombus (hence the name thrombosis), occurs at the level of a vein and obstructs it. Moreover, if this one can form at the level of any vein of the organism, however, it is generally located in the lower limbs : calf, thigh, leg…
Indeed, the venous network of the lower limbs (pelvis, thighs, knees) counts a so-called deep and superficial network :
- The deep network passes into the muscles and drains oxygen-poor blood towards the heart. It represents almost all the veins of the lower limbs. We are talking regarding deep phlebitis ;
- The superficial network, for its part, has the main role of supplying the skin. It is often the seat of varicose veins. It is a qualified secondary network which then flows into the deep network. We are talking regarding superficial phlebitis.
Generally benign, phlebitis should nevertheless encourage you to consult a doctor quickly. Indeed, it happens that in some cases, the clot migrates to the lower limbs to go to the pulmonary circulation . What can cause pulmonary embolism.
However, this is particularly the third leading cause of death following cardiovascular diseases and cancers and leading cause of death during pregnancy. In other words, do not ignore the signs of a pulmonary embolism.
Pregnancy: a major risk factor for phlebitis
Several factors can explain the formation of phlebitis. This is particularly the case of pregnancy and postpartum. “This is a risk situation for venous thromboembolic disease (VTE), because it promotes blood stagnation”explains the specialist at Medisite. “Phlebitis is regarding five times more common in pregnant women. than in the general population.
More precisely, pregnant women are four times more likely to suffer from phlebitis than outside of pregnancy. A pregnant woman, who has already suffered from phlebitis, requires specific management, as a preventive measure, with treatment administered by injection to thin the blood. Subcutaneous injections of heparin are then received daily during pregnancy and for six weeks following delivery.
Phlebitis: a suitable treatment for pregnant women
But so far, the dose of the injections given to pregnant women was still uncertain. So, to get to the bottom of this debate, an international study called Highlow, published in the journal The Lancet, compared two different doses of LMWH.
The first corresponded to a standard dose, fixed and not adapted to the weight, while the other was higher, adapted according to the weight of the woman and increased with weight gain.
The purpose of this research was to “compare, between the two groups, the number of phlebitis, pulmonary embolisms and the number of major bleedings in order to determine the dose that presented the best risk/benefit ratio for thromboembolic prevention”say the experts.
This is the largest clinical trial carried out in this field with the participation of 25 University Hospitals in France and 70 hospitals worldwide, which included 1,110 patients, including nearly 400 in France.
The prescription of a fixed standard dose is therefore the optimal dose recommended for this population at risk of recurrence, the researchers indicate.
The results finally showed that the fixed standard dose of LMWH is as effective as the weight-adjusted dose to prevent phlebitis during pregnancy. “The prescription of a fixed standard dose is therefore the optimal dose recommended for this population at risk of recurrence”, explain the researchers. “Major bleeding did not show a significant difference between the two groups.”
