Anticoagulant prophylaxis in pregnant women with a history of venous thromboembolism: A systematic review and meta-analysis
Venous thromboembolisms (such as DVTs and PEs) are leading causes of mortality amongst both pregnant and postpartum women. Identifying the symptoms of VTE and managing it correctly are essential to avoid devastating outcomes. The risk of VTE is 5 times higher during pregnancy and increases significantly postpartum. This systematic review and meta analysis aimed to examine recurrence rates of embolisms amongst 5,075 pregnant patients with prior history of VTE. This article evaluated the efficacy of LMWH as thromboprophylaxis. For pregnant patients that were anticoagulated during pregnancy and throughout the postpartum period, recurrence rates were 2.5%. This is compared to the group that received prophylaxis only postpartum which had recurrence rates of 4.7%. A third group did not receive any thromboprophylaxis and experienced a staggering 13.6% recurrence rate. This research was undertaken due to the ambiguous guidelines for thromboprophylaxis for pregnant patients. Typically, LMWH is the preferred anticoagulant, however the dosing recommendations vary. Further research is necessary to further clarify recommended guidelines for thromboprophylaxis in pregnant and postpartum women with history of VTE.