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Hamostaseologie 2024; 44(03): 218-225
DOI: 10.1055/a-2238-4681
Review Article

VTE Risk Assessment and Prevention in Pregnancy

Ellen O'Rourke
1   Mater Misericordiae University Hospital, Dublin, Ireland
,
Rehman Faryal
1   Mater Misericordiae University Hospital, Dublin, Ireland
,
Marc Blondon
2   Division of Angiology and Hemostasis, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
,
Saskia Middeldorp
3   Department of Internal Medicine, Radboud university medical center, Nijmegen, The Netherlands
,
Fionnuala Ní Áinle
4   Rotunda Hospital, Dublin, Ireland
5   Royal College of Surgeons in Ireland, Ireland
6   School of Medicine, University College, Dublin, Ireland
› Author Affiliations Funding None.
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Abstract

Venous thromboembolism (VTE) remains the leading cause of maternal mortality in pregnancy and the postpartum period. In addition to the higher pregnancy-associated baseline VTE risk, there are several well-established risk factors that can further increase the risk of VTE. At present, a thorough interrogation of these risk factors remains our only tool for estimating which pregnant people may be at an increased risk of VTE, and thus potentially benefit from thromboprophylaxis. However, an important knowledge gap still exists surrounding the duration of increased risk and the interaction of risk factors with each other. Furthermore, up to now, once significant risk has been established, prevention strategies have been largely based on expert opinion rather than high-quality data. Recent trials have successfully bridged a proportion of this knowledge gap; however, the challenge of conducting high-quality clinical trials with pregnant people remains. In this article, we provide an update on the recent evidence surrounding VTE risk factors in pregnancy while concurrently outlining knowledge gaps and current approaches to VTE prevention.

Keywords

venous thromboembolism - pregnancy - risk assessment


Publication History

Received: 07 September 2023

Accepted: 02 January 2024

Article published online:
26 February 2024

© 2024. Thieme. All rights reserved.

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