Table 3.
Recommendations for thromboprophylaxis for women with inherited thrombophilia in pregnancy.
| History of VTE | Inherited thrombophilia | Antenatal management | Postnatal management |
|---|---|---|---|
| Previous VTE | Antithrombin deficiency | 50–100% treatment dose LMWH Involve haematologist Anti-Xa monitoring |
50–100% treatment dose LMWH × 6 weeks/until oral (PO) anticoagulation started |
| All others | Consider prophylactic dose LMWH | Prophylactic dose LMWH × 6 weeks | |
| Asymptomatic | Antithrombin deficiency | ||
| Protein C deficiency | |||
| Protein S deficiency | |||
| Compound heterozygotes | |||
| Homozygous FVL | If more than one thrombophilic defect, consider prophylactic dose LMWH | If more than one thrombophilic defect, for prophylactic dose LMWH × 6 weeks | |
| Homozygous prothrombin gene mutation | |||
| Heterozygous FVL | Consider prophylactic dose LMWH in the presence of three other risk factors/from 28 weeks if two other risk factors | Prophylactic dose LMWH × 10 days if one other risk factor |
Data taken from RCOG Green-top guideline no. 37a.40
VTE: venous thromboembolism; LMWH: low-molecular-weight heparin; FVL: Factor V Leiden.