Quickshot: Trends for Inferior Vena Cava Filter Placement During Pregnancy

Out of 49 matching results, 13 papers met the inclusion criteria. Most IVC filters are indicated for failure of medical therapy despite anticoagulation and complications of anticoagulation (heparin induced thrombocytopenia, heparin allergy, significant bleeding or contraindication due to recent surgery). Relative indications include unstable or very extensive deep venous thrombosis near the time of delivery, and/or significant clot burden of the IVC. IVC filter placement was performed from 7 weeks to 41 weeks of gestation. Associated procedural complications included filter migration, fracture, thrombosis, occlusion, tilt, failed retrieval and IVC perforation. Patients who undergo IVC filter placement are at higher risk of preterm labor, leg swelling, retroperitoneal hematoma, and early fetal development disruption. Overall complication rates ascend to 19%. The use of retrievable IVC filters in this cohort has risen, especially for complicated cases, and temporary IVC filters have proven to be a safe alternative for treatment. Intravascular ultrasound (IVUS) has been proposed as an alternative to decrease radiation exposure for IVC filter deployment but has not been studied in this cohort. No clinical trials have been conducted to investigate effectiveness of IVC filter placement in this population. No specific guidelines have been established for IVC filter placement during pregnancy.

Conclusions: The decision to implant an IVC filter during pregnancy must be determined on a case dependent basis. Filter type and duration are debatable but the complication rate in this population is high. Extensive thrombosis and contraindication of anticoagulation should be considered as major indications for this treatment. IVUS guided deployment may be an alternative to reduce fetal morbidity. Further studies are required to investigate effectiveness of IVC filter placement in pregnant women and provide evidence-based guidelines.