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Advances in Hematology
Volume 2011 (2011), Article ID 157483, 6 pages
http://dx.doi.org/10.1155/2011/157483
Review Article

Obstetric Thromboprophylaxis: The Swedish Guidelines

1Department of Obstetrics and Gynecology, Karolinska University Hospital, 14186 Stockholm, Sweden
2Department of Obstetrics and Gynecology, Sahlgrenska University Hospital Gothenburg, 41345 Gothenburg, Sweden
3Department of Antenatal Care, Primary Care South Bohuslän, 43102 Molndal, Sweden

Received 28 April 2011; Accepted 5 October 2011

Academic Editor: Thomas Kickler

Copyright © 2011 Pelle G. Lindqvist and Margareta Hellgren. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Obstetric thromboprophylaxis is difficult. Since 10 years Swedish obstetricians have used a combined risk estimation model and recommendations concerning to whom, at what dose, when, and for how long thromboprophylaxis is to be administrated based on a weighted risk score. In this paper we describe the background and validation of the Swedish guidelines for obstetric thromboprophylaxis in women with moderate-high risk of VTE, that is, at similar or higher risk as the antepartum risk among women with history of thrombosis. The risk score is based on major risk factors (i.e., 5-fold increased risk of thromboembolism). We present data on the efficacy of the model, the cost-effectiveness, and the lifestyle advice that is given. We believe that the Swedish guidelines for obstetric thromboprophylaxis aid clinicians in providing women at increased risk of VTE with effective and appropriate thromboprophylaxis, thus avoiding both over- and under-treatment.