Preventing Thromboprophylaxis in the OB Population

The Society for Obstetric Anesthesia and Perinatology has published consensus guidelines that address thromboprophylaxis and norexial anesthesia considerations specifically in the OB population. For women who are receiving prophylactic low-molecular weight heparin, discontinuation is recommended at least 12 hours before scheduled induction of labor or cesarean delivery. Cesarean delivery approximately quadruples the risk of VTE in comparison with a vaginal birth but still in the otherwise normal patient the risk is still overall low about 3 in 1000 patients. Now regarding oral direct thrombin inhibitors and anti-10a inhibitors these medications should be avoided in pregnancy and during breastfeeding because