Anatomical Location and Timing of Deep Venous Thrombosis in Pregnancy and the Postpartum Period: A Narrative Literature Review

Abstract Background Pregnancy and the postpartum period are associated with an increased risk of venous thromboembolism (VTE), which has become a leading cause of maternal mortality in developed countries. Physiological and anatomical changes in pregnancy may contribute to venous stasis and endothelial injury, predisposing women to deep venous thrombosis (DVT). Objectives This review aimed to evaluate the timing and anatomical location of DVT during pregnancy and the postpartum period, and to compare these findings with non-pregnant controls. Search Strategy A literature search of Medline and Embase (1980–December 2021) was undertaken using MeSH terms: (“pregnancy” OR “gestation” OR “puerperium”) AND (“venous thrombosis” OR “VTE” OR “DVT”). Reference lists of included articles were also hand-searched to identify additional relevant studies. Selection Criteria Eligible studies were observational or retrospective, involved human subjects, were written in English, and required objective imaging confirmation of DVT. Studies limited to VTE, fertility treatment, or specific surgical populations were excluded. Data Collection and Analysis Data on DVT timing, laterality, and anatomical distribution were extracted and tabulated. Owing to heterogeneity across studies, a narrative synthesis was undertaken rather than a meta-analysis. Main Results Eighteen studies met inclusion criteria. DVT occurred more frequently in the left leg (Left 745 vs Right 216) and was predominantly proximal. The post-partum period, particularly the first six weeks after delivery, represented the highest risk interval. These patterns were not fully explained by uterine compression or gestational haemodynamic changes. Conclusions Left-sided and proximal DVTs predominate in pregnancy and post-partum, with greatest risk immediately post-delivery. Further research into venous anatomical and flow dynamics is warranted.