Table 4.

ACCP guidelines for thromboprophylaxis for women with inherited thrombophilia in pregnancy.

History of VTE/pregnancy complication	Inherited thrombophilia	Antenatal management	Postnatal management
Previous VTE	Any inherited thrombophilia	Prophylactic or intermediate dose LMWH	Prophylactic or intermediate dose LMWH × 6 weeks
Asymptomatic but has family history of VTE	Homozygous for Factor V Leiden	Prophylactic or intermediate dose LMWH	Prophylactic or intermediate dose LMWH or vitamin K antagonists (INR 2-3) × 6 weeks
	Homozygous for prothrombin gene mutation	Prophylactic or intermediate dose LMWH	Prophylactic or intermediate dose LMWH or vitamin K antagonists (INR 2-3) × 6 weeks
	Protein C or S deficiency	Thromboprophylaxis not recommended	Prophylactic or intermediate dose LMWH × 6 weeks
	All other inherited thrombophilias	Thromboprophylaxis not recommended	Prophylactic or intermediate dose LMWH or vitamin K antagonists (INR 2-3) × 6 weeks
Asymptomatic and no family history of VTE	Any inherited thrombophilia	Thromboprophylaxis not recommended	Thromboprophylaxis not recommended
Previous pregnancy complications	Any inherited thrombophilia	Thromboprophylaxis not recommended	Thromboprophylaxis not recommended
High risk of pre-eclampsia	Irrespective of thrombophilia history	Low-dose aspirin from second trimester	Thromboprophylaxis not recommended

Data taken from Bates et al.³⁸

ACCP: American College of Chest Physicians; VTE: venous thromboembolism; LMWH: low-molecular-weight heparin; INR: international normalised ratio.