Assess VTE Risk in Pregnancy
Venous thromboembolism is a leading cause of maternal morbidity. Use this scoring tool (adapted from RCOG/SMFM guidance) to identify candidates for LMWH prophylaxis.
Antenatal risk factors
Postpartum risk factors
Antenatal score
0
Postpartum score
0
Suggested management
- No routine antenatal LMWH. Emphasize hydration, mobility, and compression stockings during travel.
- Routine postpartum care; encourage mobilization and VTE symptom awareness.
How to Use This Calculator
Assess baseline risk factors early
Collect history of prior VTE, thrombophilia, BMI, and family history at booking.
Recalculate when complications arise
Update risk scoring for new events (preeclampsia, cesarean, prolonged immobility).
Discuss prophylaxis options
Use score-based recommendations to counsel on LMWH, compression, hydration, and activity.
Formula
Antenatal score = Σ (points for antenatal risk factors)
Postpartum score = Σ (points for postpartum risk factors)
Management thresholds (RCOG 2015):
- Antenatal score ≥4: LMWH throughout pregnancy and 6 weeks postpartum
- Antenatal score = 3: LMWH from 28 weeks and 6 weeks postpartum
- Postpartum score ≥2: 10 days LMWH postpartum
Full Description
Pregnancy increases VTE risk 5–10-fold, and the postpartum period is the highest risk window. Risk scoring systems (RCOG, SMFM) help target LMWH prophylaxis to women at greatest risk while minimizing bleeding complications. Combine this score with clinical judgement, bleeding risk, platelet counts, renal function, and patient preference. Encourage universal measures—hydration, early mobilization, compression stockings, and VTE symptom education.
Frequently Asked Questions
Do all women after cesarean need LMWH?
Elective cesarean adds 1 point. Additional risk factors determine whether 10-day prophylaxis is advised.
How often should scoring be repeated?
At booking, 28 weeks, hospital admissions, and postpartum before discharge.
What about aspirin?
Low-dose aspirin prevents preeclampsia but not VTE. Combine LMWH with aspirin when both indications exist.
When should LMWH be stopped for delivery?
Hold prophylactic LMWH at least 12 hours before regional anesthesia; 24 hours for therapeutic doses. Coordinate with anesthesia.