Prevention and management of venous thromboembolism in pregnancy: cutting through the practice variation

Hematology Am Soc Hematol Educ Program. 2021 Dec 10;2021(1):559-569. doi: 10.1182/hematology.2021000291.

Abstract

There is clinical practice variation in the area of prevention and management of venous thromboembolism (VTE) in pregnancy. There are limited data and differing recommendations across major clinical practice guidelines, especially relating to the role of postpartum low-molecular-weight heparin (LMWH) for patients with mild inherited thrombophilia and those with pregnancy-related VTE risk factors. This chapter explores the issues of practice variation and related data for postpartum VTE prevention. Controversial topics of VTE management in pregnancy are also reviewed and include LMWH dosing and the role of anti-Xa level monitoring, as well as peripartum anticoagulation management around labor and delivery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use
  • Delivery, Obstetric
  • Disease Management
  • Female
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnosis
  • Pregnancy Complications, Cardiovascular / etiology
  • Pregnancy Complications, Cardiovascular / prevention & control
  • Pregnancy Complications, Cardiovascular / therapy*
  • Risk Factors
  • Venous Thromboembolism / diagnosis
  • Venous Thromboembolism / etiology
  • Venous Thromboembolism / prevention & control
  • Venous Thromboembolism / therapy*
  • Young Adult

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight