Venous Thromboembolism in Pregnancy and Postpartum Care

Venous thromboembolism (VTE), manifesting chiefly as deep vein thrombosis (DVT) or pulmonary embolism (PE), represents a leading cause of maternal morbidity and mortality worldwide. The physiological adaptations of pregnancy—hypercoagulability, venous stasis from uterine compression and altered endothelial function—combine with traditional risk factors such as advanced maternal age, obesity, inherited thrombophilia, caesarean delivery, pre-eclampsia and infection to elevate VTE risk by approximately fivefold during gestation and up to sixtyfold in the first six weeks after birth. Clinical assessment incorporates validated risk‐scoring tools, laboratory markers (including D-dimer adjusted for gestational age) and imaging modalities tailored to minimise foetal exposure. Thromboprophylaxis strategies centre on low-molecular-weight heparin (LMWH) as first-line therapy, with unfractionated heparin reserved for specific peri-operative or high-bleeding-risk scenarios. Timing, dosing and duration of prophylaxis are determined by individual risk stratification, extending into the postpartum period for high-risk women. Emerging research focuses on refining predictive algorithms, integrating global haemostasis assays and exploring novel oral anticoagulants. Harmonisation of international guidelines, coupled with education and digital alert systems, has demonstrably improved prophylaxis uptake, underscoring the global imperative to translate advances into standardised, accessible care pathways.

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Venous Thromboembolism in Pregnancy and Postpartum Care publication trend

The graph below shows the total number of articles in venous thromboembolism in pregnancy and postpartum care across all publications each year (not limited to Nature Index journals).

Technical terms

Venous thromboembolism (VTE): The formation of blood clots in the venous circulation, encompassing deep vein thrombosis and pulmonary embolism.

Deep vein thrombosis (DVT): A clot within a deep vein, typically in the lower limbs, which can lead to pain, swelling and risk of embolisation.

Pulmonary embolism (PE): Obstruction of a pulmonary artery by a dislodged thrombus, causing acute respiratory and cardiovascular compromise.

Thromboprophylaxis: Preventive measures, typically anticoagulant therapy, aimed at reducing the risk of clot formation.

Low-molecular-weight heparin (LMWH): A class of heparins with predictable pharmacokinetics, used widely for anticoagulation during pregnancy due to safety and ease of dosing.

Thrombophilia: A hereditary or acquired predisposition to thrombus formation, often due to specific mutations or deficiencies in coagulation factors.

References

1. Low-molecular-weight heparins utilization in pregnant and postpartum women: a real-world analysis in China (2016–2021). Frontiers in Pharmacology (2025).
2. Evaluating Thromboprophylaxis Strategies for High-Risk Pregnancy: A Current Perspective. Pharmaceuticals (2024).
3. Critical appraisal of international guidelines for the prevention and treatment of pregnancy-associated venous thromboembolism: a systematic review. BMC Cardiovascular Disorders (2019).