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Thrombosis and Embolism during Pregnancy and the Puerperium, Reducing the Risk (Green-top Guideline No. 37a)

Published: 13/04/2015

This is the third edition of this guideline, first published in 2004 under the title ‘Thromboprophylaxis during Pregnancy, Labour and after Vaginal Delivery’ and revised in 2009 under the title ‘Reducing the Risk of Thrombosis and Embolism during Pregnancy and the Puerperium’.


Update May 2018: New evidence and guidance in this field were reviewed at the May 2018 Guidelines Committee meeting and it was decided that revision of this guideline would be deferred for 1 year (May 2019). The version available on the website and app will remain valid until replaced.


The aim of this guideline is to provide advice, based on clinical evidence where available, regarding the prevention of venous thromboembolism (VTE) during pregnancy, birth and following delivery. For the diagnosis and management of acute VTE in pregnancy, please refer to Green-top Guideline No. 37b: The Acute Management of Thrombosis and Embolism during Pregnancy and the Puerperium

For anticoagulation for mechanical heart valves in pregnancy, read the chapter covering this within the proceedings of the RCOG study group on heart disease - a summary of the guideline for antenatal and postnatal thromboprophylaxis is given in Appendix I.