The Obstetrician & Gynaecologist 2007;9:1:3-8
doi: 10.1576/toag.9.1.003.27289
Copyright © 2007 by the Royal College of Obstetricians and Gynaecologists.
A clinical approach to the management of thrombosis in obstetrics. Part 2: diagnosis and treatment of venous thromboembolism
Farah Asghar, MMedSc, MRCOG, Specialist Registrar1 and
Paul Bowman, FRCOG, FRCPI, Consultant Obstetrician and Gynaecologist2
1. Coombe Women's Hospital, Dublin 8, Republic of Ireland. Email: farahasghar{at}doctors.org.uk (corresponding author)
2. Coombe Women's Hospital, Dublin 8, Republic of Ireland.
Key content:
- The diagnosis of venous thromboembolism requires objective testing, which can be done safely throughout pregnancy.
- Low molecular weight heparin is the most suitable agent for both prophylaxis and treatment of venous thromboembolism in pregnancy.
- Once labour has commenced, heparin should not be administered.
- It is recommended that anticoagulants be resumed 4–6 hours after vaginal delivery and 6–12 hours after caesarean delivery.
Learning objectives:
- To be able to choose the most appropriate diagnostic tests for venous thromboembolism in pregnancy.
- To be able to prescribe the most appropriate anticoagulants.
- To be able to manage women on anticoagulants appropriately during the different stages of pregnancy.
Ethical issues:
- The risks to the fetus of anticoagulant therapy are outweighed by the health benefits to the mother.
- Women of reproductive age on oral anticoagulants should know about warfarin embryopathy.
Please cite this article as: Asghar F, Bowman P. A clinical approach to the management of thrombosis in obstetrics. Part 2: diagnosis and treatment of venous thromboembolism. The Obstetrician & Gynaecologist 2007;9:3–8.
Keywords low molecular weight heparin / pregnancy / pulmonary embolism / unfractionated heparin / venous thromboembolism
Copyright © 2007 by the Royal College of Obstetricians and Gynaecologists.
