Introduction:
Venous Thromboembolic Disease [VTED] leading to a Pulmonary Embolism is a leading cause of maternal death in the UK and venous thromboembolism complicates ~1.2 in every 1000 deliveries. A significant number of fatal antenatal VTE events occur in the first trimester of pregnancy and therefore, all women should undergo a VTE risk assessment in early pregnancy or pre-pregnancy. This should be repeated if a woman is admitted to hospital for any reason and again intrapartum or post-partum . The absolute risk of VTED in pregnancy is low and therefore, a risk assessment algorithm allows the identification of at-risk women and who may benefit from thromboprophylaxis with a Low Molecular Weight Heparin [LMWH].
Estimating the Risk of VTED in Pregnancy
The Royal College of Obstetricians & Gynaecologists have published guidelines on the assessment of women for VTED in pregnancy and pre-pregnancy and the management of women who have developed a venous thrombosis/pulmonary embolism in pregnancy - see References for additional information.
The RCOG risk assessment algorithm is summarised below. A number of other risk assessment protocols have been developed - see References.