Venous Thromboembolism and Pregnancy: Prevention and Treatment

Pregnancy-related venous thromboembolism (VTE) remains a leading cause of maternal morbidity and mortality. Physiologic changes in pregnancy, along with patient-specific and pregnancy-specific risk factors, increase this VTE risk. The prevention and treatment of pregnancy-related VTE is often complex and requires the careful consideration of variation in clinical guidelines, VTE risk profile, bleeding assessment, careful delivery planning and patient preference. The mainstay of treatment for an acute VTE in pregnancy is the use of low-molecular-weight heparin. In this review, we highlight three clinical cases to review clinical approaches to the prevention and treatment of VTE in pregnancy in these scenarios. Importantly, this review goes over the current understanding of the pathophysiology and clinical practice experience for pregnant patients with VTE. We also explored the variation in professional clinical guidelines on VTE prophylaxis and treatment strategies in pregnancy, and how these guidelines may be interpreted in the context of patient care for optimal outcomes.