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Recommendations for the prevention of pregnancy‐associated venous thromboembolism
Author(s) -
McLINTOCK Claire,
BRIGHTON Tim,
CHUNILAL Sanjeev,
DEKKER Gus,
McDONNELL Nolan,
McRAE Simon,
MULLER Peter,
TRAN Huyen,
WALTERS Barry N.J.,
YOUNG Laura
Publication year - 2012
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2011.01357.x
Subject(s) - medicine , venous thromboembolism , pregnancy , intensive care medicine , population , evidence based medicine , evidence based practice , medline , clinical trial , risk assessment , alternative medicine , obstetrics , surgery , thrombosis , genetics , environmental health , computer security , pathology , political science , computer science , law , biology
Pregnancy is a risk factor for venous thromboembolism (VTE), an important cause of maternal morbidity and mortality. Although there is a 4–5‐fold increased risk compared to that of nonpregnant women of the same age, the absolute risk is low at no more than two episodes of VTE per 1000 pregnancies. There is uncertainty about which women require thromboprophylaxis during pregnancy or postpartum because of a lack of data from appropriate clinical trials. For this reason, recommendations for prophylaxis should be made only after explaining the available evidence to the patient and taking into account her perception of the balance of risk and benefit in thromboprophylaxis. The aim of these recommendations is to provide clinicians with practical advice to assist in decisions regarding thromboprophylaxis in women considered to be at risk of VTE during pregnancy and the postpartum. The authors are clinicians from across New Zealand and Australia representing the fields of haematology, obstetric medicine, anaesthesiology, maternal–fetal medicine and obstetrics. Authors were invited to review the relevant literature and then worked collaboratively to devise recommendations and resolve areas of controversy. The recommendations contained herein were reached by consensus and represent the opinion of the panel. The absence of randomised clinical trials in this area limits the strength of evidence that can be used, and it is acknowledged that they represent level C evidence. The panel advocates for appropriate clinical studies to be carried out in this patient population to address the inadequacy of present evidence.