Clinical Inquiries

Should you test or treat pregnant women with a history of pregnancy-related VTE?

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References

Recommendations

The American College of Obstetricians and Gynecologists (ACOG) 2011 updated Practice Bulletin recommends thrombophilia testing for pregnant patients previously diagnosed with a pregnancy-associated VTE, although they acknowledge the lack of quality evidence to support this recommendation. ACOG also recommends ante- and postpartum thromboprophylaxis for such patients.9

The ACCP expert review recommends that all pregnant women diagnosed with VTE during a previous pregnancy wear graduated elastic compression stockings throughout pregnancy and for at least 6 weeks postpartum.7

The ACCP also recommends LMWH for all pregnant patients with a prior VTE. Additionally, the ACCP says that a thrombophilia work-up, while not routinely recommended, might be appropriate—contingent on additional risk assessment.7

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Evidence-based answers from the Family Physicians Inquiries Network

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