What LMWH dose is used for prophylaxis in pregnancy?

Enoxaparin 40 mg SQ daily (standard prophylaxis). Obese women (BMI >40 or weight >100 kg): enoxaparin 40 mg SQ BID or dalteparin 5,000 IU BID. Anti-Xa monitoring (target 0.2-0.4 IU/mL at 4h post-dose) recommended for high BMI or renal impairment.

When should LMWH be stopped before delivery?

Prophylactic LMWH: last dose 12 hours before planned delivery/epidural. Therapeutic LMWH: last dose 24 hours before. Regional anaesthesia can be placed 12h after prophylactic and 24h after therapeutic dose. Resume 6-12h after delivery.

What RCOG risk score justifies antenatal thromboprophylaxis?

RCOG 2015: score 4+ before delivery = antenatal LMWH from first trimester; score 3 = from 28 weeks. High-risk factors (4 points each): previous VTE, antiphospholipid syndrome. Multiple moderate factors accumulate to trigger threshold.

VTE Risk and LMWH Prophylaxis Dosing in Pregnancy

Assess VTE risk and calculate LMWH (enoxaparin/dalteparin) prophylactic and therapeutic dosing for pregnant and postpartum women using RCOG/ACCP thromboprophylaxis guidelines and weight-based dosing adjustments.

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VTE Risk and LMWH Prophylaxis Dosing in Pregnancy

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Frequently Asked Questions

What LMWH dose is used for prophylaxis in pregnancy?

When should LMWH be stopped before delivery?

What RCOG risk score justifies antenatal thromboprophylaxis?