The Guideline for Thromboprophylaxis and Treatment of Venous Thromboembolism in Obstetrics: Guideline for VTE

Abstract

Venous Thromboembolism (VTE) is one of the preventable but poorly reported causes of maternal morbidity and mortality in developing countries. Data on the prevalence of VTE in obstetric population in Nigerian is scanty,attributableto low index of clinical suspicion as well as paucity of diagnostic capability. The aim of this guideline is to provide clinical guidance based on the best available evidence in the prevention and treatment of venous thromboembolism in the Nigerian obstetric population. Certain innate and acquired factors have been found to increase the risk of developing VTE. These risk factors have enabled the development of risk assessment tools for prophylaxis. It is recommended that VTE risk assessment should be done for all pregnant women at booking for antenatal care, whenever they are admitted into the hospital and during vaginal delivery, emergency and elective Caesarean section, and also in the puerperium. Thromboprophylaxis is centered on the use of Low Molecular Weight (LMWH) or unfractionated heparin (UFH) based on the identified risk factor(s). It is also important to diagnose pregnant women who develop Deep Venous Thrombosis (DVT)and/or Pulmonary Embolism (PE). LMWH or UFH are recommended for treatment of DVT and/or PE with or without certain non-pharmacological methods. A consensual acceptance and utilization of this guideline is expected to change the narrative of VTE in the obstetric population in Nigeria and other developing countries.