Action
Obtain compression ultrasonography of symptomatic leg
Decision
Is compression ultrasonography positive for DVT?
Yes → Initiate anticoagulation with LMWH
Background
According to the American Society of Hematology 2018 guidelines for management of venous thromboembolism in the context of pregnancy, the following treatment should be considered in pregnant women:
- Low Molecular Weight Heparin (LMWH) is recommended over unfractionated heparin for treatment of venous thromboembolism (VTE). (strong recommendation)
- LMWH is also recommended for treatment of superficial vein thrombosis in pregnant women. (conditional recommendation)
- LMWH dosing can be once or twice a day. (conditional recommendation)
Source:
Bates S, Rajasekhar A, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: venous thromboembolism in the context of pregnancy. Blood Adv 2018; 2 (22): 3317–3359. Full Text
