Pulmonary embolism Q&As
Published by Bupa's health information team, March 2009.
Answers to questions about pulmonary embolism
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- What is the risk of getting a pulmonary embolism when using the contraceptive pill?
- Will I be at risk of pulmonary embolism if I take a long flight?
- Could anticoagulants harm my unborn baby?
What is the risk of getting a pulmonary embolism when using the contraceptive pill?
Women taking second generation pills (eg Cilest, Microgynon, Ovranette) have a three-fold increase in risk of getting a deep vein thrombosis (DVT) or pulmonary embolism. Those on third generation pills (eg Femodene) have a six-fold increase in risk. However, the actual numbers of women affected are very small.
Explanation
Although you may have an increased risk of getting a DVT or pulmonary embolism if you take the contraceptive pill, it is still rare to get one of these conditions. Only about 15 in 100,000 women who take second generation pills and 30 in 100,000 women who take third generation pills get a DVT or pulmonary embolism every year. This compares with about five in 100,000 women who don't take the contraceptive pill.
However, your overall risk may be much higher if you take the contraceptive pill in addition to having other risk factors for DVT and pulmonary embolism, such as having a blood clotting disorder or having a personal or family history of DVT. Because of this, your doctor will ask you about your medical history before you start taking the contraceptive pill.
Women taking the contraceptive pill also have a small increase in risk in getting a DVT during surgery. If you are going to have surgery, your doctor will talk to you about the risks and benefits of stopping the pill beforehand. The small reduction you may get in your risk of DVT has to be balanced against the risk of unplanned pregnancy if you stop taking the pill.
Sources
- Prophylaxis of venous thromboembolism. Scottish Intercollegiate Guidelines Network (SIGN), October 2002. www.sign.ac.uk
- British National Formulary (BNF), BMJ Publishing Group, 2007. 55:121-125
- British Thoracic Society. British Thoracic Society guidelines for the management of suspected acute pulmonary embolism. Thorax 2003; 58:470-484
- Robinson GV. Pulmonary embolism in hospital practice. BMJ 2006; 332:156-160
Will I be at risk of pulmonary embolism if I take a long flight?
Flying, and long journeys in general may increase the risk of getting a blood clot and a pulmonary embolism. However, most people who develop deep vein thrombosis (DVT) and pulmonary embolism after a long flight also have other risk factors for the disease.
Explanation
Sitting down for a long period of time, as on a long flight, means that your legs will be immobile for a long time. This can increase risk of a blood clot in your leg (DVT), which can then travel to your lungs (pulmonary embolism).
Other factors that can lead to the increased risk of DVT and pulmonary embolism when flying include:
- the cramped position of the aeroplane seat
- dehydration
- compression of the vein behind your knee, by the edge of the seat
Remember that most travellers who develop DVT also have other risk factors.
To reduce your risk of DVT when flying:
- drink lots of water
- don't drink too much alcohol or coffee (these can cause dehydration)
- do simple leg exercises and take occasional walks around the aircraft
If you're at high risk for DVT (eg if you're pregnant, have recently had surgery or have had DVT before) and will be travelling for more than six hours, your doctor may advise you to wear compression stockings. They may also advise you to have an injection of heparin immediately before you travel. Ask your doctor for advice before you fly.
Sources
- British Thoracic Society. British Thoracic Society guidelines for the management of suspected acute pulmonary embolism. Thorax 2003; 58:470-484
- Prophylaxis of venous thromboembolism. Scottish Intercollegiate Guidelines Network (SIGN), October 2002. www.sign.ac.uk
- Robinson GV. Pulmonary embolism in hospital practice. BMJ 2006; 332:156-160
- Venous thrombosis and air travel. The Circulation Foundation. www.circulationfoundation.org.uk, accessed 6 March 2008
Could anticoagulants harm my unborn baby?
Some anticoagulants (drugs used to prevent the blood from clotting) shouldn't be taken if you're pregnant, as they could be harmful to a developing baby (fetus). This includes the drug warfarin. If you are pregnant and need to take an anticoagulant, your doctor will usually advise you to use a low-molecular-weight heparin, as this is safer.
Explanation
You may need to take an anticoagulant while pregnant if your doctor thinks you are at risk from developing deep vein thrombosis and pulmonary embolism.
Anticoagulants that you take by mouth, such as warfarin, shouldn't be taken during pregnancy. This is because they can cross the placenta (which delivers oxygen and nutrients to the baby) and cause harm to the developing fetus.
Low molecular weight heparin is used in pregnant women who need anticoagulant treatment, as it does not cross the placenta, and so will not reach the fetus. If you were already taking an oral anticoagulant such as warfarin before you became pregnant, you will be advised to switch to a low molecular weight heparin as soon as your pregnancy is confirmed.
Sometimes you may be told you need to continue using low molecular weight heparin after the birth of your baby. This may be for up to six weeks, depending on how high your risk of getting a blood clot is.
Both warfarin and low molecular weight heparin can be taken while breastfeeding.
Sources
- British National Formulary (BNF), BMJ Publishing Group, 2007. 55:121-125
- Prophylaxis of venous thromboembolism. Scottish Intercollegiate Guidelines Network (SIGN), October 2002. www.sign.ac.uk
- British Thoracic Society. British Thoracic Society guidelines for the management of suspected acute pulmonary embolism. Thorax 2003; 58:470-484
Related topics
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: March 2009
Pulmonary embolism factsheet
Visit the pulmonary embolism health factsheet for more information.
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