Thromboprophylaxis in pregnancy

Indications for prophylaxis

Patient	FHx of VTE?	Prophylaxis
Prior VTE with provoked, transient risk factor	—	None
Prior VTE either unprovoked or estrogen-related	—	Antepartum and postpartum
Homozygous Factor V Leiden	Yes	Antepartum and postpartum
Homozygous prothrombin gene mutation	Yes	Antipartum and postpartum
Antithrombin-III deficiency	Yes	Antepartum and postpartum
Other thrombophilia	Yes	Postpartum only
Homozygous Factor V Leiden	No	Postpartum only
Homozygous prothrombin gene mutation	No	Postpartum only
Other thrombophilia	No	None
Antithrombin-III deficiency	No	None

Prophylaxis regimens

Timing	Management
Antepartum	Prophylactic or intermediate-dose LMWH
Postpartum	Prophylactic or intermediate-dose LMWH, or warfarin (INR 2-3), for 6 weeks