Critical appraisal of international guidelines for the prevention and treatment of pregnancy-associated venous thromboembolism: a systematic review

Table 2 Summary of recommendations on prevention of obstetric-associated venous thromboembolism

	ACCP [12]	ACOG [13]	ANZJOG [14]	ASH [16]	Australia [17]	AVTF [18]	ESC [19]	JOGNN [21]	Korea [22]	RCOG [23]	SASTH [25]
Pregnant patients
Anticoagulant choice	LMWH UFH (×)		LMWH		LMWH Warfarin	LMWH	LMWH	LMWH UFH	LMWH Warfarin(×)	LMWH	LMWH NOAC(×)
Low risks	×		×	×	×	×	×	×
Moderate to high risk	Prophylactic- or intermediate dose LMWH		Prophylactic LMWH	Prophylactic LMWH	LMWH or Adjusted dose warfarin	LMWH or mechanical prophylaxis	LMWH or mechanical prophylaxis	Prophylactic-dose LMWH or UFH
Cesarean section
Anticoagulant choice	LMWH				LMWH warfarin		LMWH		warfarin LMWH	LMWH
Low risks	×				√				×		×
Moderate risks	prophylactic LMWH or mechanical prophylaxis		mobilize early, mechanical prophylaxis		LMWH for 5–7d or mechanical prophylaxis		LMWH for 7d	prophylactic-dose LMWH or UFH 6w		LMWH for 10d	LMWH
High risk	prophylactic LMWH and mechanical prophylaxis for 6w		prophylactic LMWH or Warfarin for 6w		LMWH or adjusted therapeutic dose warfarin to 6w		LMWH for 6w and mechanical prophylaxis	treatment-dose LMWH or UFH 6w		LMWH for 6w
Inherited thrombophilia
Screening	×	×	×				×		×
Prevention	×	×	×						√	√

ACCP, American College of Chest Physicians; ACOG, American College of Obstetricians and Gynecologists; ANZJOG, Australian and New Zealand Journal of Obstetrics and Gynaecology; AVTF, Asian Venous Thrombosis Forum; ESC, European Society of Cardiology; JOGNN, Journal of Obstetric, Gynecologic & Neonatal Nursing; LMWH, Low Molecular Weight Heparin; NOAC, Novel Oral Anticoagulants; SASTH, Southern African Society of Thrombosis and Haemostasis; UFH, Unfraction Heparin

ISSN: 1471-2261