The Use of a Scoring System to Guide Thromboprophylaxis in a High-Risk Pregnant Population

Table 3

The Thromboprophylaxis Scoring System.

Risk factor	Score
Age >35 years	0.5
Weight >120 kg	0.5
VTE in two or more first or second degree relatives	0.5
Previous nonobstetric provoked VTE	1.0
Previous nonobstetric unprovoked VTE	2.0
Previous VTE on the combined oral contraceptive pill	2.0
Previous obstetric VTE*	2.0
Antithrombin deficiency (use anticoagulant dose adjusted for weight)	3.0
Protein C deficiency**	1.5
Protein S deficiency**	1.0
Factor V Leiden**	1.0
Prothrombin gene mutation (G20210A)**	1.0
Antiphospholipid antibodies***	1.0
Total Score

Total score/Thromboprophylaxis: Under 1.0: conservative management, lifestyle advice; 1.0–1.5: from delivery until 6 weeks postpartum; 2.0–2.5: from 28 weeks until 6 weeks postpartum; 3.0 or more: from diagnosis of pregnancy until 6 weeks postpartum; *begin therapy at least 4 weeks before the gestation of the previous VTE; **pregnancy long therapy for homozygous conditions; ***individualised care for recurrent pregnancy loss.
VTE: venous thromboembolism. 'Precipitated' refers to VTE following an identifiable cause such as trauma, surgery, immobilisation, air travel or malignant disease.