There are updated guidelines for treating thrombosis in pregnant patients.
The American College of Chest Physicians (ACCP) has published updated guidelines for the prevention, treatment, and management of thrombosis in populations such as pregnant women, children, and hospitalized patients.
For women who are pregnant or wish to become pregnant while undergoing long-term antithrombotic therapy, the guidelines recommend that vitamin K antagonists such as warfarin be stopped before 6 weeks of fetal gestation for most women, as they can cause birth defects or miscarriage. Low-molecular-weight heparin or unfractionated heparin should be substituted prior to conception or a confirmed pregnancy, although long-term use is associated with osteoporosis.
The guidelines recommend the routine use of thromboprophylaxis for patients undergoing major general, gynecologic, orthopedic, bariatric, and coronary artery bypass surgery. In general, the guidelines recommend thromboprophylaxis for most hospitalized patients, except those at very low risk of VTE, e.g., patients undergoing laparoscopic surgery or knee arthroscopy, or those who take long airplane flights.