Chapter 2: Thrombosis and thromboembolism

Thromboembolism: Specific recommendations

There is an urgent need for a guideline on the management of obese pregnant women with a BMI over 35.

Public information and education messages are necessary so that women at risk of problems in pregnancy because of their weight, family history or past history can seek advice before pregnancy.

Health professionals must be aware that women are at risk of thromboembolism from the very beginning of pregnancy. Guidelines for the management of women at risk of thromboembolism are contained in the Annex to this Chapter.

At booking, a full risk and needs assessment must be undertaken before maternity care plans are decided. Because of their co-morbidity, obese women with a BMI of 35 or more are unsuitable for midwife-only care.

Telephone consultations require particular care because early symptoms of life-threatening embolism are generally mild and reassurance is too easy to give and accept.

Thromboprophylaxis should be a routine part of the management of ovarian hyperstimulation syndrome.