Deep vein thrombosis (DVT) in the lower extremities is a common disease in vascular surgery. Deep venous thrombosis (DVT) is an abnormal clotting of blood in the lumen of the deep veins, blocking the venous cavity and leading to venous return obstruction, which can lead to pulmonary embolism in the acute stage and affect the ability to work in the later stage due to post-thrombotic syndrome if left untreated. The incidence of DVT is increasing year by year with the improvement of people’s living standard, the change of diet structure and the progress of vascular disease detection technology. It has become an important disease that threatens life and affects the quality of life. The causes of DVT are complex and were summarized by German pathologist Virchow as early as 1856 as three major factors: including hypercoagulable state, venous stasis and vascular injury. There is a clinical category of people who are prone to DVT, namely women during pregnancy and childbirth, which is mainly related to the enhancement of the above three factors in women during pregnancy and childbirth. After giving birth, dealing with DVT will be simpler compared to pregnant women who are still in pregnancy, because the safety of the fetus has to be taken into account in the choice of treatment plan, and the treatment time for DVT is longer, especially for pregnant women in early pregnancy, and the long pregnancy period increases many unpredictable risks. This morning, another pregnant woman with left lower limb DVT at 21 weeks of gestation, surnamed Liang, 27 years old, was transferred to the ward from the obstetrics department, and the swelling of her left lower limb was very serious. The family was very nervous and kept asking the doctor what to do. The family’s nervousness is understandable, after all, this is a matter of two lives and the happiness of several families. This reminds me of a similar case a year ago. At that time, two pregnant women with DVT were transferred to the ward, one was transferred from an outside hospital, surnamed Li, so we called her Xiao Li, and the other was transferred from the obstetrics department of our hospital, surnamed Liu, so we called her Xiao Liu. Xiao Li is 33 years old, 18 weeks pregnant, from Zhanjiang, currently working in Guangzhou with her husband, already has a girl, 7 years old, because she is a rural household, there is still a birth indicator, all these years have been trying to have another one, this time it is difficult to get pregnant, but the DVT is complicated, the left lower limb swelling is serious. Xiao Liu is 32 years old, 15 weeks pregnant, Guangzhou native, married for 7 years, has a history of two miscarriages before this pregnancy, the couple has been running around the obstetrics and gynecology departments of major hospitals in Guangzhou over the years in order to have a child, this time the current fetus is fine, but it is complicated by DVT, also swelling of the left lower limb. What should Xiao Li and Xiao Liu do? There are anticoagulation, thrombolysis, surgical removal of embolus and symptomatic treatment for DVT, but the treatment of DVT in pregnancy is different from ordinary patients because it is necessary to consider both the safety of the pregnant woman and the preservation of the fetus. According to the American College of Chest Physicians (ACCP) guidelines, the main treatment principle for DVT in pregnancy is anticoagulation. Anticoagulants such as heparin, low-molecular heparin, warfarin, and rivaroxaban are commonly used in clinical practice. Heparin and low molecular heparin do not pass through the placenta and have no fetal teratogenic effect, while warfarin can pass through the placenta and has teratogenic effect, so it is not advocated during pregnancy, and rivaroxaban is prohibited during pregnancy. Although heparin and low-molecular heparin can be used for DVT in pregnancy, there is still a risk of bleeding, especially with heparin, which requires constant blood sampling to monitor coagulation, while low-molecular heparin is used as the first choice, but the treatment time is longer, anticoagulation is required throughout pregnancy, and the cost is high. In addition, although the available information indicates that low-molecular heparin is relatively safe, there are many inconveniences and risks during the long pregnancy, so before determining the treatment plan, it is first clear whether the fetus is to be preserved or not. Initially, Li and Liu and their families understandably wanted to keep the fetus, but after explaining the treatment options and risks, Li’s husband began to hesitate. Because the monthly cost is quite a lot, it is also a relatively large pressure for them, so it is understandable that the expectations are high. As the doctor in charge, I can only tell him from the existing evidence-based medical basis and personal experience that it should be safer and have a better chance, but I really don’t dare to guarantee it, in case the person is empty, it will be a big blow to their family. After much back-and-forth, the Li family finally decided not to keep the fetus. That night, when I was on duty night check, I saw Xiao Li lying on her side on the pillow, crying out in pain, and could only gently comfort her, but could not bear to ask too many questions, followed by the check-in intern, a girl, accompanied by tears. After listening to the treatment plan, Xiao Liu couple may have experienced the alternating sadness and joy of the two previous pregnancies and two miscarriages, very frankly, without a trace of hesitation, the whole family insisted on keeping the baby. Prudently, after deciding on the low-molecular heparin anticoagulation option, she was once again told of the risks, costs, the need to receive many injections on her body, and even to learn to give injections herself, because it was impossible to stay in the hospital for the whole pregnancy. Xiao Liu remained calm after hearing this, and said a sentence that impresses me to this day: “Even if I have a thousand holes, I still want to bo “. After Xiao Li was transferred to the obstetrics department to induce labor, she was switched to warfarin oral anticoagulation, the dose was adjusted according to the coagulation function in the outpatient clinic, and the anticoagulation was discontinued after 3 months, and the symptoms of the lower extremities basically disappeared, and then she never came back for a review. The female intern who shed tears that night, after transferring the department met me and asked how this patient is now, I said the leg is well, thinking, I hope God will give Xiao Li another chance, suddenly turned around and asked the female student: “Is that the first time you shed tears for the patient?” One day, received a phone call from the director of obstetrics Zhang, said there is a consultation, the consultation sheet folder in the case, is my former patient, should have an impression of the. I went to the obstetrics ward and as soon as I entered, I heard someone greet me, it was Xiao Liu, next to the BB bed was her baby, beautiful, Xiao Liu looked at the BB, the side of happiness and pride was unforgettable. The consultation was about the transition of anticoagulants. Director Zhang said, this patient is really not easy, her husband did not dare to give her low-molecular heparin injection, it is her own injection, now the whole belly hard, touching the bumpy, I said yes, she is now finally bitter and sweet. Director Zhang talked about feeling more patients of this kind, and said that he always bothered you to come over for consultations and so on.