Prevention and management of venous thromboembolism in pregnancy

Pulmonary thromboembolism is a major cause of maternal mortality. DVT causes significant morbidity in pregnancy and in later life owing to the post-thrombotic syndrome. Obstetricians must have an understanding of the risk factors for VTE, the appropriate use of prophylaxis, the need for objective diagnosis in women with suspected VTE, and the appropriate use of anticoagulant therapy. Greater use of prophylaxis is needed after vaginal delivery. Because acute VTE is relatively uncommon, greater use of proposed guidelines [24,84,85] may be of value in improving management, but the involvement of clinicians with expertise in the management of these cases is also important.