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Women with a previous venous thromboembolism associated with pregnancy/contraception should perform antithrombotic prophylaxis during pregnancy and in the puerperium: 98% agreement

Pregnant women with a history of VTE present with the benefit of using antithrombotic prophylaxis during the entire gestation and puerperium periods, thus reducing the risk of VTE recurrence.(6)


Women with factor V Leiden thrombophilia in homozygosis or mutant prothrombin, with no past venous thromboembolism and no family history of thrombosis should have prophylaxis only in the postpartum period: 75% agreement

The literature recommends performing prophylaxis during puerperium (Level of Evidence 2B);(6) however, due to great discordance during the meeting, it was established that there is need for prophylaxis both during pregnancy and puerperium. The rationale is in accordance with the new publication of October 2017, in which a systematic review of 36 meta-analyses demonstrated the due use of prophylaxis both in pregnancy and in the puerperium, regardless of women’s family history.(28)

Therefore, women with factor V Leiden thrombophilia in homozygosis or mutant prothrombin in homozygosis, with no previous VTE and no family history of thrombosis should have prophylaxis during pregnancy and puerperium.
Women with factor V Leiden thrombophilia in homozygosis or mutant prothrombin in homozygosis, with no previous venous thromboembolism and with a family history of thrombosis, should have antithrombotic prophylaxis both during pregnancy and puerperium: 98% agreement

The homozygous women for the mutation of the LVF and with a positive family history present with a chance lower those 47 events for each 1,000 when prophylaxis is used.(6)


Women with thrombophilia (all other thrombophilias, except homozygous factor V Leiden and mutation of prothrombin 20210 homozygous), with no past thromboembolism, and with no family history of thrombosis should perform clinical vigilance during pregnancy and during puerperium: 92% agreement

There are no data confirming efficacy of antithrombotic prophylaxis in this population, and clinical observation in these cases is recommended.(6)


Women with thrombophilia (all other thrombophilias, except homozygous factor V Leiden and mutation of prothrombin 20210), with no previous venous thromboembolism event, and with family history of thrombosis, should perform clinical surveillance during pregnancy, and antithrombotic prophylaxis in the puerperium: 94% agreement

In women with a positive family history for VTE and patients with a deficiency of antitrombin III, of protein C or of protein S, antithrombotic prophylaxis demonstrates reduction in the estimated number of prevented TEVs (13 in 1,000).(4,6,29)




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