ACOG Practice Bulletin No. 196: Thromboembolism in Pregnancy
Abstract
Women who are pregnant or in the postpartum period have a fourfold to fivefold increased risk of thromboembolism compared with nonpregnant women (). Approximately 80% of thromboembolic events in pregnancy are venous (), with a prevalence of 0.5-2.0 per 1,000 pregnant women (). Venous thromboembolism (VTE) is one of the leading causes of maternal mortality in the United States, accounting for 9.3% of all maternal deaths ().The prevalence and severity of this condition during pregnancy and the peripartum period warrant special consideration of management and therapy. Such therapy includes the treatment of acute thrombotic events and prophylaxis for those at increased risk of thrombotic events. The purpose of this document is to provide information regarding the risk factors, diagnosis, management, and prevention of thromboembolism, particularly VTE in pregnancy. This Practice Bulletin has been revised to reflect updated guidance regarding screening for thromboembolism risk and management of anticoagulation around the time of delivery.
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Approximately 80% of thromboses occurring in pregnancy are venous.
“Consistently, approximately 80% of thromboses occurring in pregnancy are venous [90].”
From Estrogen and thrombosis: a bench to bedside review (2020) · cites this paper as [90]
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Ensom, M. H. H., & Stephenson, M. D. (2004) · Journal of the Society for Gynecologic Investigation · doi:10.1016/j.jsgi.2004.02.007 · Cited by 44 · see citing works
James, A., Abel, D. E., & Brancazio, L. R. (2005) · Obstetrical & Gynecological Survey · doi:10.1097/01.ogx.0000193878.57208.ad · Cited by 41 · see citing works
Áinle, F. N., Wong, A., Appleby, N., Byrne, B., Regan, C. L., Hassan, T., Milner, M., Sullivan, A. O., White, B., & O’Donnell, J. S. (2008) · Blood Coagulation & Fibrinolysis · doi:10.1097/mbc.0b013e32830b14ef · Cited by 38 · see citing works
Retrievable vena cava filters: Key considerations
Imberti, D., & Prisco, D. (2007) · Thrombosis Research · doi:10.1016/j.thromres.2007.06.017 · Cited by 36 · see citing works
Prevention of Venous Thromboembolism in Pregnancy: A Review of Guidelines, 2000–2011
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Association Between Polycystic Ovary Syndrome and Glucose Intolerance During Pregnancy
Lesser, K. B., & García, F. (1997) · The Journal of Maternal-Fetal Medicine · doi:10.1002/(sici)1520-6661(199709/10)6:5 · Cited by 32 · see citing works
Boban, A., Paulus, S., Lambert, C., & Hermans, C. R. J. R. (2016) · Blood Coagulation & Fibrinolysis · doi:10.1097/mbc.0000000000000573 · Cited by 25 · see citing works
Timing of postpartum enoxaparin administration and severe postpartum hemorrhage
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Heparin-Induced Thrombocytopenia during Obstetric Hospital Admissions
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Treatment of deep venous thrombosis in pregnant women
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Risk of Warfarin During Pregnancy With Mechanical Valve Prostheses
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Risk of Postoperative Venous Thromboembolism Among Pregnant Women
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Mehta, L. S., Warnes, C. A., Bradley, E., Burton, T., Economy, K., Mehran, R., Safdar, B., Sharma, G., Wood, M., Valente, A. M., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000772 · Cited by 464 · see citing works
Bollag, L., Lim, G., Sultan, P., Habib, A. S., Landau, R., Zakowski, M., Tiouririne, M., Bhambhani, S., & Carvalho, B. (2021) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000005257 · Cited by 378 · see citing works
Estrogen and thrombosis: a bench to bedside review
Abou-Ismail, M. Y., Citla Sridhar, D., & Nayak, L. (2020) · Thrombosis Research · doi:10.1016/j.thromres.2020.05.008 · Cited by 261 · see citing works
- Venue
- Obstetrics & Gynecology
- Published
- 2018-07
- Volume
- 132
- Issue
- 1
- Pages
- e1-e17
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W4235921685
- Cited by
- 515
- References
- 102
- Citations by year
- 2026: 77 · 2025: 90 · 2024: 71 · 2023: 76 · 2022: 58 · 2021: 54 · 2020: 57 · 2019: 28 · 2018: 4
- FWCI
- 33.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- thromboembolism in pregnancy, venous thromboembolism, postpartum thromboembolism, maternal mortality, thromboembolic risk factors, thromboprophylaxis, anticoagulation management, transition period
- MeSH terms
- Anticoagulants, Female, Humans, Pregnancy, Pregnancy Complications, Cardiovascular, Prenatal Diagnosis, Risk Factors, Delivery, Obstetric, Postpartum Period, Venous Thromboembolism
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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