title: Prevention of venous thromboembolism in pregnancy: a review of guidelines, 2000-2011.
abstract: BACKGROUND
  Pregnant women are four to five times more likely than nonpregnant women to develop venous thromboembolism (VTE). The aim of this review is to provide an overview of guidelines in the literature on VTE risk assessment, screening for thrombophilias, and thromboprophylaxis dissemination among pregnant women.
  
  
  METHODS
  We performed a review of the published literature to identify evidence-based guidelines published between the years 2000 and 2011. We searched for guidelines from U.S. and international organizations that identified clinically based practice recommendations to healthcare providers on how VTE risk should be assessed, thrombophilias screened, and thromboprophylaxis disseminated among pregnant women.
  
  
  RESULTS
  We found nine guidelines that met our requirements for assessing VTE risk and found seven guidelines addressing thrombophilia screening. Seven of the nine agreed that all women should undergo a risk factor assessment for VTE either in early pregnancy or in the preconception period. Seven of the nine agreed that pregnant women with more than one additional VTE risk factor be considered for thromboprophylaxis, and five of the seven groups addressing thrombophilia screening agreed that selected at-risk populations should be considered for thrombophilia screening.
  
  
  CONCLUSIONS
  There is some agreement between U.S. and international guidelines that women should be assessed for VTE risk during preconception and again in pregnancy. Although there is agreement that the general population of women should not be screened for thrombophilias, no agreement exists as to the clinical subgroups for which screening should be done.
authors.affiliation: Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. eokoroh@cdc.gov
authors.forename: Ekwutosi M
authors.initials: EM
authors.lastname: Okoroh
authors.forename: Ijeoma C
authors.initials: IC
authors.lastname: Azonobi
authors.forename: Scott D
authors.initials: SD
authors.lastname: Grosse
authors.forename: Althea M
authors.initials: AM
authors.lastname: Grant
authors.forename: Hani K
authors.initials: HK
authors.lastname: Atrash
authors.forename: Andra H
authors.initials: AH
authors.lastname: James
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D002585:Cesarean Section; D005260:Female; D006801:Humans; D008403:Mass Screening; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000517:prevention & control*; D018570:Risk Assessment; D012307:Risk Factors; D019851:Thrombophilia / Q000150:complications / Q000235:genetics; D054556:Venous Thromboembolism / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants