Preventing venous thromboembolism during pregnancy and postpartum: crossing the threshold

Leslie Skeith

doi:10.1182/asheducation-2017.1.160

Preventing venous thromboembolism during pregnancy and postpartum: crossing the threshold

Hematology Am Soc Hematol Educ Program. 2017 Dec 8;2017(1):160-167. doi: 10.1182/asheducation-2017.1.160.

Author

Leslie Skeith¹

Affiliation

¹ Division of Hematology, Department of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.

Abstract

When should a patient with a known thrombophilia or prior venous thromboembolism (VTE) receive low-molecular-weight heparin (LMWH) prophylaxis during pregnancy and/or the postpartum period? Accurately predicting thrombotic and bleeding risks and knowing what to do with this information is at the heart of decision-making in these challenging scenarios. This article will explore the concept of a risk threshold from clinician and patient perspectives and provide guidance for the use of antepartum and postpartum LMWH prophylaxis in women with a known thrombophilia or prior VTE. Advice for the management of LMWH prophylaxis use around labor and delivery is also reviewed.

Publication types

Review

MeSH terms

Female
Heparin, Low-Molecular-Weight / therapeutic use*
Humans
Postpartum Period*
Pregnancy
Pregnancy Complications / prevention & control*
Thromboembolism / prevention & control*

Substances

Heparin, Low-Molecular-Weight