**6.6 Practical and useful tips**


**165**

*Vein Thrombosis Risk in Women and Travel DOI: http://dx.doi.org/10.5772/intechopen.92229*

birth) in healthy pregnant women [5, 53–57, 60].

which for the fetuses are negligible [61].

**7. Conclusion**

tion is controversial.

air travel.

People suffering from diseases that increase the risk of venous thromboembolism should follow the guidelines above, and the possibility of administering low molecular weight heparin (2–4 h before or earlier before flying) may also be considered. In patients receiving anticoagulants, the dose should be reassessed.

Overall, however, there is insufficient data on pregnancy complications after

Occasional air travel, especially in the second trimester, is safe for healthy pregnant women and their child, according to the current state of knowledge, and has no negative effects on the course of pregnancy. Before starting the flight, the gynecologist should carefully ascertain the patient's own (pre-existing illnesses) and obstetric history, as well as individually check the previous course of pregnancy (pregnancy-related risks) to identify pregnant women with risk factors who are advised against traveling by air. In any case, it is advisable to consider the different conditions of carriage of the airlines (including mandatory certification) and to obtain information about the destination of the flight. A drop-in air pressure, a reduction in partial oxygen pressure, and air humidity are generally not a problem for healthy pregnant women and their children. Dehydration during long-haul flights should be avoided. A radiation dose of 1 mSV should not be exceeded during pregnancy; pregnant women with frequent long-haul flights near the pole (e.g., Europe-North America) should take care of this. Most people believe that commercial air travel does not increase the risk of pregnancy complications (e.g., premature

The estimated radiation dose for infants/toddlers should be 0.05 μSV/scan,

Travel thrombosis in connection with long-haul flights (>4 h flight time) are rare (about 1/4500 passengers) and mostly affect the deep veins of the calf muscles. The proportion of pulmonary embolisms is significantly higher for female passengers than for male passengers (flight duration > 12 h: 4.8–7.2/1 million). The risk of venous thromboembolism depends primarily on the duration of the flight, the number of flights within 4 weeks, and individual thrombogenic risk factors. As a result of hypercoagulability and venous stasis, the risk for pregnant women is increased, and it is estimated at 0.03–0.1%. Long-term immobilization is the most important predisposing factor; the importance of hypobaric hypoxia and dehydra-

Before starting the flight, especially pregnant women are advised to carefully assess their risks. To reduce risk, in addition to general measures (e.g., physical activity), wearing graded, well-fitting compression stockings is recommended and if there is a high individual risk (e.g., previous VTE), prophylaxis administration of

low molecular weight heparin before and immediately after the flight.

#### *Vein Thrombosis Risk in Women and Travel DOI: http://dx.doi.org/10.5772/intechopen.92229*

*Tourism*

**Medium risk**

**High risk**

• No aspirin.

Pregnancy, puerperium.

compression in ankle).

Additional (grade 2C/2D):

women who are not allowed [5, 53–56].

**6.6 Practical and useful tips**

legs.

• Wear comfortable clothing.

• Take regular breaks to walk.

• Drink plenty of liquids.

(2–6 h before travel).

Previous VTE, symptomatic thrombophilia.

flight and 1–3 days after the flight (individual decision).

**6.5 What causes vein thrombosis and pulmonary embolism?**

• Customized, graduated compression stockings to the knee (15–30 mmHg

• Low molecular weight heparin (e.g., 5000 IU dalteparin s.c.) 6–12 h before the

Clots can be formed at various points, in the legs and in the thighs, with similar problems. All veins have valves every 10–12 cm, and some of them can form clots. If the clot stays there, then the member has swelling and pain. Small fever may occur, and the member may be warmer. The most serious complication, however, is pulmonary embolism (PE), which occurs in 25% of cases with thrombosis. If the clot is detached, it is transported through the veins and eventually clamped to the lung. The condition can appear immediately or even 2 weeks after the long journey. The most common symptoms to suspect pulmonary embolism are sudden chest pain, dyspnea, dizziness, fever, hemoptysis, etc. Symptoms depend on the size of the plunger and the size of the vessel, the age of the person, if he or she is suffering from other diseases, etc. Immediate admission to the hospital is required for diagnosis and special treatment. In rare cases, a part of the clot can cause embolism in other organs, such as the brain.

People predisposed to thrombosis, as well as patients with previously mentioned

• Leave space under the front seat to allow freedom of movement for the lower

• For persons at high risk of thrombosis, elastic compression with special socks is recommended and sometimes administration of low molecular weight heparin

• Change your posture regularly and do exercises for your feet.

illnesses, should be consulted by their physician prior to long journeys. In these individuals, it is recommended to inject antithrombotic (heparin) once 24 h before flight. It is also recommended to take aspirin before takeoff, except for pregnant

**164**

People suffering from diseases that increase the risk of venous thromboembolism should follow the guidelines above, and the possibility of administering low molecular weight heparin (2–4 h before or earlier before flying) may also be considered.

In patients receiving anticoagulants, the dose should be reassessed.

Overall, however, there is insufficient data on pregnancy complications after air travel.

Occasional air travel, especially in the second trimester, is safe for healthy pregnant women and their child, according to the current state of knowledge, and has no negative effects on the course of pregnancy. Before starting the flight, the gynecologist should carefully ascertain the patient's own (pre-existing illnesses) and obstetric history, as well as individually check the previous course of pregnancy (pregnancy-related risks) to identify pregnant women with risk factors who are advised against traveling by air. In any case, it is advisable to consider the different conditions of carriage of the airlines (including mandatory certification) and to obtain information about the destination of the flight. A drop-in air pressure, a reduction in partial oxygen pressure, and air humidity are generally not a problem for healthy pregnant women and their children. Dehydration during long-haul flights should be avoided. A radiation dose of 1 mSV should not be exceeded during pregnancy; pregnant women with frequent long-haul flights near the pole (e.g., Europe-North America) should take care of this. Most people believe that commercial air travel does not increase the risk of pregnancy complications (e.g., premature birth) in healthy pregnant women [5, 53–57, 60].

The estimated radiation dose for infants/toddlers should be 0.05 μSV/scan, which for the fetuses are negligible [61].
