SAT

VTE score

Risk assessment for venous thromboembolism (VTE)

• If total score ≥ 4 antenatally, consider thromboprophylaxis from the first trimester.
• If total score 3 antenatally, consider thromboprophylaxis from 28 weeks.
• If total score ≥ 2 postnatally, consider thromboprophylaxis for at least 10 days.
• If admitted to hospital antenatally consider thromboprophylaxis.
• If prolonged admission (≥ 3 days) or readmission to hospital within the puerperium consider thromboprophylaxis.
• For patients with an identified bleeding risk, the balance of risks of bleeding and thrombosis should be discussed in consultation with a haematologist with expertise in thrombosis and bleeding in pregnancy.

Contraindications/cautions to LMWH use

• Known bleeding disorder (e.g. haemophilia, von Willebrand’s disease or acquired coagulopathy)
• Active antenatal or postpartum bleeding
• Women considered at increased risk of major haemorrhage (e.g. placenta praevia)
• Thrombocytopenia (platelet count < 75 × 109/l)
• Acute stroke in previous 4 weeks (haemorrhagic or ischaemic)
• Severe renal disease (glomerular filtration rate [GFR] < 30 ml/minute/1.73m2)
• Severe liver disease (prothrombin time above normal range or known varices)
• Uncontrolled hypertension (blood pressure > 200 mmHg systolic or > 120 mmHg diastolic)

Conscents

• Methotrexate
• IOL
• DIL
• Lapratomy

Guidelines

• Ectopic Pregnancy NICE guidelines
• Diabetic Ketosis of Pregnency TOG guidelines