Venous thromboembolism bundle: Risk assessment and prophylaxis for obstetric patients

While venous thromboembolism (VTE) is a leading cause of severe maternal morbidity and mortality, maternal death from VTE is amenable to prevention. Thromboprophylaxis is the most readily implementable means of systematically reducing the maternal death rate, and protocols that identify at-risk women have led to a significant reduction in maternal deaths from VTE. Strategies to prevent VTE require minimal resources. A multidisciplinary working group convened as part of American Congress of Obstetricians and Gynecologists' District II Safe Motherhood Initiative reviewed research evidence and major society thromboprophylaxis guidelines and identified clinical strategies to reduce maternal VTE risk. This review provides recommendations for VTE prophylaxis and describes suggested clinical strategies for office and hospital-based implementation.