TABLE 3.
Clinical recommendations on thromboprophylaxis for pregnant and postpartum women with confirmed or suspected COVID‐19
| Isolating at home | Inpatient hospitalized for non‐COVID‐related reason but asymptomatic or minor symptoms such as anosmia | Inpatient with pneumonia requiring supplementary oxygen but not ventilation | Inpatient with pneumonia requiring mechanical ventilation | |||
|---|---|---|---|---|---|---|
| Low risk pregnancy and low risk for VTE | Risk factors for VTE – not receiving thromboprophylaxis | Receiving thromboprophylaxis | ||||
| ANTEPARTUM | Encourage hydration and mobilization | Conduct risk assessment & consider thromboprophylaxis on an individual basis | Continue thromboprophylaxis | Conduct risk assessment & consider thromboprophylaxis on an individual basis | Give thromboprophylaxis (LMWH) | Give thromboprophylaxis (LMWH) ‐ dose according to local critical care protocol |
| PERIPARTUM | NA | Follow local policy for interruption of anticoagulation prior to delivery | ||||
| POSTPARUM (while in hospital) | Usual care | Conduct risk assessment & consider thromboprophylaxis on an individual basis | Continue usual thromboprophylaxis | Conduct risk assessment & consider thromboprophylaxis on an individual basis | Give thromboprophylaxis (LMWH) | Give thromboprophylaxis (LMWH) ‐ dose according to local critical care protocol |
| POSTPARUM (upon discharge) |
Usual care Encourage hydration and mobilization |
Usual care & consider thromboprophylaxis on an individual basis. Encourage hydration and mobilization |
Decision based on primary indication for thromboprophylaxis. Encourage hydration and mobilization |
Conduct risk assessment & consider thromboprophylaxis on an individual basis Encourage hydration and mobilization |
Conduct risk assessment & consider extended thromboprophylaxis on an individual basis. Encourage hydration and mobilization |
Conduct risk assessment & consider extended thromboprophylaxis on an individual basis. Encourage hydration and mobilization |
LMWH, low molecular weight heparin; NA, not applicable; SARS‐CoV‐2, Severe Acute Respiratory Syndrome Coronavirus 2; VTE, venous thromboembolism.