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Chokri Ben Lamine – VTE Prophylaxis in Pregnancy (ASH 2018 Guidelines)
Sep 6, 2025, 14:04

Chokri Ben Lamine – VTE Prophylaxis in Pregnancy (ASH 2018 Guidelines)

Dr. Chokri Ben Lamine, Adult Hematology and Stem Cell Transplantation Assistant Consultant at Oncology Center of Excellence at King Faisal Specialist Hospital and Research Center, shared an insightful post on X:

“ASH 2018 VTE Prophylaxis in Pregnancy

Prior VTE

  • Unprovoked / hormone-related → Antepartum: Yes, Postpartum: Yes
  • Provoked (transient risk only) → Antepartum: No, Postpartum: Yes

Thrombophilia
Heterozygous FVL / Prothrombin G20210A

  • No FHx → Antepartum: No, Postpartum: No
  • +FHx → Antepartum: No, Postpartum: Yes

Protein C deficiency

  • No FHx → Antepartum: No, Postpartum: No
  • +FHx → Antepartum: No, Postpartum: Yes

Protein S deficiency

  • No FHx → Antepartum: No, Postpartum: No
  • +FHx → Antepartum: No, Postpartum: Yes

Compound heterozygosity

  • No FHx → Antepartum: No, Postpartum: Yes
  • +FHx → Antepartum: Yes, Postpartum: Yes

Homozygous FVL

  • No FHx → Antepartum: No, Postpartum: Yes
  • +FHx → Antepartum: Yes, Postpartum: Yes

Homozgous Prothrombin

  • No FHx → Antepartum: No, Postpartum: No
  • +FHx → Panel unable to recommend, Postpartum: Yes

Antithrombin deficiency

  • No FHx → Antepartum: No, Postpartum: No
  • +FHx → Antepartum: No, Postpartum: Yes

Other risks

  • No or 1 risk factor → Antepartum: No, Postpartum: Yes
  • Assisted reproduction →

-Without ovarian hyperstimulation / high-risk → Antepartum: No

-With OHSS or high-risk thrombophilia → Antepartum: Yes, Postpartum: Yes

Pearls for exams

  • Postpartum period = highest risk → most recommendations support prophylaxis here
  • Antepartum prophylaxis reserved for high-risk thrombophilia with FHx or prior unprovoked/hormonal VTE
  • LMWH = preferred agent

Reference: ASH-SAP 9th Ed, Table 3-2”

Chokri Ben Lamine – VTE Prophylaxis in Pregnancy (ASH 2018 Guidelines)

More series on VTE featured in Hemostasis Today.

ASH Chokri Ben Lamine FHx FVL Health Hematology Hemostasis Hemostasis Today LMWH Medicine OHSS Oncology Center of Excellence Pregnancy thrombosis VTE
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