Practice Guidelines

NPMS Releases Consensus Statement on Venous Thromboembolism During Pregnancy


Am Fam Physician. 2017 Mar 15;95(6):397-398.

Author disclosure: No relevant financial affiliations.

Key Points for Practice

• At the first prenatal visit, VTE risk should be evaluated and prophylaxis should be given based on recommendations similar to those from the ACOG and ACCP.

• Antepartum women at low risk of bleeding or impending birth who have been in the hospital for 72 hours or more should be given LMWH once per day or UFH twice per day.

• Postpartum women with multiple previous VTE episodes, previous VTE and high-risk thrombophilia, or previous VTE and acquired thrombophilia should be given treatment-dose LMWH or UFH for six weeks.

From the AFP Editors

Maternal morbidity and mortality are commonly caused by venous thromboembolism (VTE), which accounts for approximately 9% to 31% of pregnancy-related deaths, depending on the country. The main strategy for preventing VTE-related mortality is thromboprophylaxis, but guidance regarding its use differs across specialties and organizations, including the Royal College of Obstetricians and Gynaecologists (RCOG), the American College of Obstetricians and Gynecologists (ACOG), and the American College of Chest Physicians (ACCP).

For this reason, the National Partnership for Maternal Safety (NPMS), a group made up of a variety of leaders in women's health care, has created a safety bundle to review current guidance and make recommendations. The aim is to have all the birthing centers in the United States adapt this bundle to their patients and resources, rather than a single national protocol. The bundle is an overview of current recommendations to help guide application and create uniformity across practices. This document was developed by official representatives from the American Association of Blood Banks; the American Academy of Family Physicians; the American College of Nurse-Midwives; the ACOG; the Association of Women's Health, Obstetric and Neonatal Nurses; the Society for Maternal-Fetal Medicine; and the Society for Obstetric Anesthesia and Perinatology.

Outpatient Antepartum

At the first prenatal visit,

Author disclosure: No relevant financial affiliations.

Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of Practice Guidelines published in AFP is available at



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Feb 15, 2018

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