Prevention of Postpartum Venous Thromboembolism.
Importance: Postpartum venous thromboembolism (VTE) results in significant morbidity and mortality. The practicing obstetrician-gynecologist should have a plan for management and prevention. Objective: The objective of this review is to familiarize obstetric providers with available evidence regarding postpartum VTE prevention and suggest a clinical practice guideline. Evidence Acquisition: Published literature was retrieved through a search of PubMed and relevant review articles, original research articles, systematic reviews, and practice guidelines. Results: Thromboembolic disease is one of the leading causes of maternal death in developed nations. Current evidence does not support universal postpartum VTE prophylaxis. Risk factor stratification is suggested to identify patients at high risk of VTE. Recent guidelines have recommended complex algorithms that are difficult to put into practice and have not been validated in the postpartum state. The American College of Obstetricians and Gynecologists has recommended that each institution develop a protocol to identify and treat women at high risk of postpartum VTE. Conclusions and Relevance: Obstetric providers should be familiar with available evidence and best practice regarding postpartum VTE prevention. A suggested clinical practice guideline for the prevention of postpartum VTE is provided.
Clinton, CM; Kuller, JA; James, AH
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