Venous thromboembolic and bleeding complications among pregnant women with Klippel-Trenaunay syndrome

Elizabeth K. Marvin, Jennifer J. Schoch, Henry Nguyen, Katelyn R. Anderson, David J. Driscoll, Carl H. Rose, Emily C. Bendel, Megha M Tollefson

Research output: Contribution to journalArticle

Abstract

Background: Klippel-Trenaunay syndrome (KTS) is a vascular malformation overgrowth syndrome characterized by capillary malformation, venous malformation, and limb overgrowth, with or without lymphatic malformation. Patients are at an increased risk of hemorrhage and venous thromboembolism (VTE). Consequently, women with this condition often are counseled to avoid pregnancy, but minimal data are available on the relationship between pregnancy, VTE, and bleeding risk. Objective: To review the risk of VTE and bleeding in pregnant and nulligravid women with KTS. Methods: A retrospective medical record review was performed of women with KTS, aged ≥18 years, evaluated at Mayo Clinic Rochester, Minnesota, from August 1945 to April 2018. Results: We identified 75 women with ≥1 pregnancy and 64 nulligravid women. VTE prevalence was 14 of 70 (20%) for women with a history of pregnancy and 16 of 64 (25%) for nulligravid women (P = .93). Among the 70 women with a history of pregnancy, 7 of 18 VTE events (39%) occurred in association with pregnancy, with VTE affecting 7 of 151 pregnancies (4.6%). Significant bleeding prevalence was 6 of 70 (8.6%) for women with a history of pregnancy and 6 of 64 (9.4%) for nulligravid women (P = .54). Limitations: This was a retrospective review. Conclusion: The prevalence of VTE and bleeding was similar in patients with KTS, irrespective of pregnancy status.

Original languageEnglish (US)
JournalJournal of the American Academy of Dermatology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Klippel-Trenaunay-Weber Syndrome
Venous Thromboembolism
Pregnant Women
Hemorrhage
Pregnancy
Reproductive History
Vascular Malformations
Medical Records
Extremities

Keywords

  • bleeding
  • deep vein thrombosis
  • hemorrhage
  • Klippel-Trenaunay syndrome
  • pregnancy
  • pulmonary embolism
  • venous thromboembolic

ASJC Scopus subject areas

  • Dermatology

Cite this

Venous thromboembolic and bleeding complications among pregnant women with Klippel-Trenaunay syndrome. / Marvin, Elizabeth K.; Schoch, Jennifer J.; Nguyen, Henry; Anderson, Katelyn R.; Driscoll, David J.; Rose, Carl H.; Bendel, Emily C.; Tollefson, Megha M.

In: Journal of the American Academy of Dermatology, 01.01.2019.

Research output: Contribution to journalArticle

Marvin, Elizabeth K. ; Schoch, Jennifer J. ; Nguyen, Henry ; Anderson, Katelyn R. ; Driscoll, David J. ; Rose, Carl H. ; Bendel, Emily C. ; Tollefson, Megha M. / Venous thromboembolic and bleeding complications among pregnant women with Klippel-Trenaunay syndrome. In: Journal of the American Academy of Dermatology. 2019.
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abstract = "Background: Klippel-Trenaunay syndrome (KTS) is a vascular malformation overgrowth syndrome characterized by capillary malformation, venous malformation, and limb overgrowth, with or without lymphatic malformation. Patients are at an increased risk of hemorrhage and venous thromboembolism (VTE). Consequently, women with this condition often are counseled to avoid pregnancy, but minimal data are available on the relationship between pregnancy, VTE, and bleeding risk. Objective: To review the risk of VTE and bleeding in pregnant and nulligravid women with KTS. Methods: A retrospective medical record review was performed of women with KTS, aged ≥18 years, evaluated at Mayo Clinic Rochester, Minnesota, from August 1945 to April 2018. Results: We identified 75 women with ≥1 pregnancy and 64 nulligravid women. VTE prevalence was 14 of 70 (20{\%}) for women with a history of pregnancy and 16 of 64 (25{\%}) for nulligravid women (P = .93). Among the 70 women with a history of pregnancy, 7 of 18 VTE events (39{\%}) occurred in association with pregnancy, with VTE affecting 7 of 151 pregnancies (4.6{\%}). Significant bleeding prevalence was 6 of 70 (8.6{\%}) for women with a history of pregnancy and 6 of 64 (9.4{\%}) for nulligravid women (P = .54). Limitations: This was a retrospective review. Conclusion: The prevalence of VTE and bleeding was similar in patients with KTS, irrespective of pregnancy status.",
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AU - Anderson, Katelyn R.

AU - Driscoll, David J.

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N2 - Background: Klippel-Trenaunay syndrome (KTS) is a vascular malformation overgrowth syndrome characterized by capillary malformation, venous malformation, and limb overgrowth, with or without lymphatic malformation. Patients are at an increased risk of hemorrhage and venous thromboembolism (VTE). Consequently, women with this condition often are counseled to avoid pregnancy, but minimal data are available on the relationship between pregnancy, VTE, and bleeding risk. Objective: To review the risk of VTE and bleeding in pregnant and nulligravid women with KTS. Methods: A retrospective medical record review was performed of women with KTS, aged ≥18 years, evaluated at Mayo Clinic Rochester, Minnesota, from August 1945 to April 2018. Results: We identified 75 women with ≥1 pregnancy and 64 nulligravid women. VTE prevalence was 14 of 70 (20%) for women with a history of pregnancy and 16 of 64 (25%) for nulligravid women (P = .93). Among the 70 women with a history of pregnancy, 7 of 18 VTE events (39%) occurred in association with pregnancy, with VTE affecting 7 of 151 pregnancies (4.6%). Significant bleeding prevalence was 6 of 70 (8.6%) for women with a history of pregnancy and 6 of 64 (9.4%) for nulligravid women (P = .54). Limitations: This was a retrospective review. Conclusion: The prevalence of VTE and bleeding was similar in patients with KTS, irrespective of pregnancy status.

AB - Background: Klippel-Trenaunay syndrome (KTS) is a vascular malformation overgrowth syndrome characterized by capillary malformation, venous malformation, and limb overgrowth, with or without lymphatic malformation. Patients are at an increased risk of hemorrhage and venous thromboembolism (VTE). Consequently, women with this condition often are counseled to avoid pregnancy, but minimal data are available on the relationship between pregnancy, VTE, and bleeding risk. Objective: To review the risk of VTE and bleeding in pregnant and nulligravid women with KTS. Methods: A retrospective medical record review was performed of women with KTS, aged ≥18 years, evaluated at Mayo Clinic Rochester, Minnesota, from August 1945 to April 2018. Results: We identified 75 women with ≥1 pregnancy and 64 nulligravid women. VTE prevalence was 14 of 70 (20%) for women with a history of pregnancy and 16 of 64 (25%) for nulligravid women (P = .93). Among the 70 women with a history of pregnancy, 7 of 18 VTE events (39%) occurred in association with pregnancy, with VTE affecting 7 of 151 pregnancies (4.6%). Significant bleeding prevalence was 6 of 70 (8.6%) for women with a history of pregnancy and 6 of 64 (9.4%) for nulligravid women (P = .54). Limitations: This was a retrospective review. Conclusion: The prevalence of VTE and bleeding was similar in patients with KTS, irrespective of pregnancy status.

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