Abstract

To identify current strategies and recommendations for venous thromboembolism prophylaxis associated with the pregnancy-puerperal cycle, a condition of high morbidity and mortality among women. The literature search was performed between May and October 2019, using the PubMed database, including papers published in Portuguese, English and Spanish. The terms thromboembolism (Mesh) AND pregnancy (Mesh) OR postpartum (Mesh) were used as descriptors, including randomized controlled trials, meta-analyses, systematic reviews and guidelines published from 2009 to 2019, presenting strategies for prevention of thromboembolism during pregnancy and the postpartum. Eight articles met the inclusion criteria. Many studies evaluated were excluded because they did not address prevention strategies. We compiled the recommendations from the American Society of Hematologists, the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynecologists, the Society of Obstetricians and Gynaecologists of Canada, the American College of Chest Physicians and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. There are some gaps in the research, and clinical studies with appropriate methodology are needed to support decisions made regarding the risk of thromboembolism in the perigestational period. Thus, the attention of the professionals involved in the care of pregnant and postpartum women is crucial, as it is a condition associated with high morbidity and mortality.

Highlights

  • Venous thromboembolism (VTE), manifested as pulmonary embolism (PE) or deep-vein thrombosis (DVT), affects $ 1 to 2 per 1,000 pregnancies

  • We compiled the recommendations from the American Society of Hematologists, the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynecologists, the Society of Obstetricians and Gynaecologists of Canada, the American College of Chest Physicians and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists

  • There are some gaps in the research, and clinical studies with appropriate methodology are needed to support decisions made regarding the risk of thromboembolism in the perigestational period

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Summary

Introduction

Venous thromboembolism (VTE), manifested as pulmonary embolism (PE) or deep-vein thrombosis (DVT), affects $ 1 to 2 per 1,000 pregnancies. The risk of VTE exists beginning in the first 3 months of pregnancy, before anatomical alterations become visible.[5] It persists during the whole pregnancy, increases in the 3rd trimester, and markedly rises during the postpartum.[6,7] Statistically, the number of incidences during pregnancy is similar to the puerperium, but considering the shorter duration of the postpartum, the daily risk is higher during the first weeks after giving birth, especially the first 7 days, when 50% of such events occur.[8]

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