Understanding Postpartum VTE Prophylaxis: Confusion and Considerations

Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is responsible for 9–30% of pregnancy-related mortality in high resource countries and remains a significant, increasing cause of severe maternal morbidity. Peripartum, 50% of VTE events occur in the postpartum interval, which has a 6-fold higher risk compared to antepartum. There is wide variation in LMWH pharmacological postpartum prophylaxis guidance. The RCOG, for example, recommends 10 days of LMWH for all postop CS patients unless it was elective, and additional risk factors exist. The ACOG uses a more selective approach. However, on Jan 16, 2025, a new multicenter retrospective study from the US is raising questions about the efficacy of postpartum VTE pharmacologic therapy. Is there really no need for pp VTE pharmacologic therapy? Or does the answer lie in the reality of VTE as a “low frequency, high acuity” event? Listen in for details!