Society for Maternal-Fetal Medicine: Thromboembolism prophyl
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Venous thromboembolism is a major cause of maternal morbidity and mortality. The risk of venous thromboembolism is particularly elevated during the postpartum period and especially after cesarean delivery. There is considerable variation in the approach to prophylaxis of venous thromboembolism in pregnancy, including after cesarean delivery. This Consult discusses the different guidelines on the prophylaxis of venous thromboembolism after cesarean delivery and provides recommendations based on
the available evidence.

The recommendations by the Society for Maternal-Fetal Medicine are as follows:

1. All women who undergo cesarean delivery receive sequential compression devices starting before surgery and that the compression devices be used continuously until the patient is fully ambulatory (GRADE 1C)

2. Women with a previous personal history of deep
venous thrombosis or pulmonary embolism who undergo cesarean delivery receive both mechanical (starting preoperatively and continuing until ambulatory) and pharmacologic (for 6 weeks postoperatively) prophylaxis

3.Women with a personal history of an inherited thrombophilia (high-risk or low-risk) but no previous thrombosis who undergo cesarean delivery receive both mechanical (starting preoperatively and continuing until ambulatory) and pharmacologic (for 6 weeks postoperatively) prophylaxis

4. The uses of low-molecular-weight heparin as the preferred thromboprophylactic agent in pregnancy and the postpartum period

5. When pharmacologic thromboprophylaxis is needed in pregnant women with class III obesity, it suggested using intermediate doses of enoxaparin

Source: https://www.smfm.org/publications/327-smfm-consult-series-51-thromboembolism-prophylaxis-for-cesarean-delivery
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