CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2020; 80(01): 48-59
DOI: 10.1055/a-1030-4546
GebFra Science
Review/Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Prophylaxis and Therapy of Venous Thrombotic Events (VTE) in Pregnancy and the Postpartum Period

Article in several languages: English | deutsch
Christoph Sucker
Gerinnungszentrum Berlin Dr. Sucker, Berlin, Germany
› Author Affiliations
Further Information

Publication History

received 08 February 2019
revised 21 August 2019

accepted 17 October 2019

Publication Date:
26 November 2019 (online)

  

Abstract

Venous thromboembolisms and pulmonary embolisms are one of the main causes of morbidity and mortality in pregnancy. The increased risk of thrombotic events caused by the physiological changes during pregnancy alone does not justify any medical antithrombotic prophylaxis. However, if there are also other risk factors such as a history of thromboses, hormonal stimulation as part of fertility treatment, thrombophilia, increased age of the pregnant woman, severe obesity or predisposing concomitant illnesses, the risk of thrombosis should be re-evaluated – if possible by a coagulation specialist – and drug prophylaxis should be initiated, where applicable. Low-molecular-weight heparins (LMWH) are the standard medication for the prophylaxis and treatment of thrombotic events in pregnancy and the postpartum period. Medical thrombosis prophylaxis started during pregnancy is generally continued for about six weeks following delivery due to the risk of thrombosis which peaks during the postpartum period. The same applies to therapeutic anticoagulation after the occurrence of a thrombotic event in pregnancy; here, a minimum duration of the therapy of three months should also be adhered to. During breastfeeding, LMWH or the oral anticoagulant warfarin can be considered; neither active substance passes into breast milk.