Glossary

Term · Postpartum: Your Body

Virchow's triad

Also: Virchow triad, Virchow's triad of thrombosis

The three factors that together raise the risk of a blood clot: a sticky blood state, slowed blood flow, and damage to the vein wall. Pregnancy touches all three.

In plain words

Virchow's triad is a classic way of explaining why blood clots form. Named for the German pathologist Rudolf Virchow, it lists three factors. The first is blood that clots more easily. The second is blood that moves more slowly through a vein. The third is injury to the lining of a vein. Pregnancy and birth can affect all three. Clotting factors rise, veins in the pelvis and legs can be pressed on, and a birth can injure a vein. Knowing the triad helps clinicians decide who needs more care, such as movement, hydration, or medicine to lower clot risk. It is an explanation, not a diagnosis.

The deeper version

Virchow's triad (Virchow, Die Cellularpathologie, 1858) organizes thrombogenesis into hypercoagulability, venous stasis, and . In pregnancy, hypercoagulability reflects increased fibrinogen and factors VII, VIII, and X, with von Willebrand factor elevated and protein S decreased; venous stasis reflects progesterone-mediated venodilation and mechanical compression of the iliac veins and inferior vena cava by the gravid uterus, more often on the left; and endothelial change occurs at delivery. The ACCP guideline (Bates et al., 2012) applies this framework to thromboprophylaxis decisions in pregnancy and the puerperium. The triad explains the higher risk without quantifying it, and its individual components are measured with different tools, so its use is mainly conceptual.

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Sources

  • Virchow R — Die Cellularpathologie in ihrer Begründung auf physiologische und pathologische Gewebelehre, 1858
  • Bates SM et al. — Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012
  • American College of Obstetricians and Gynecologists — Practice Bulletin 196: Thromboembolism in Pregnancy, 2018

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