Preventing Blood Clots After Delivery in Women at Moderate Risk Using Blood Thinners or No Medicine

What this Trial Is About

Venous thromboembolism VTE is the second leading cause of death among women of reproductive age worldwide. The risk of VTE is particularly notable during pregnancy and postpartum, with half of VTE cases occurring after delivery, mainly as pulmonary embolism. Women at intermediate risk for postpartum VTE, often due to factors like obesity, cesarean section, or postpartum hemorrhage, currently lack clear evidence on the effectiveness and safety of preventive medication during this period. This open-label, randomized controlled trial compares two strategies to prevent postpartum VTE in women at intermediate risk pharmacological thromboprophylaxis using low molecular weight heparin LMWH for six weeks after delivery versus no pharmacological thromboprophylaxis. The LMWH type and dosage depend on physician and patient preference, with options including enoxaparin, tinzaparin, dalteparin, or nadroparin, adjusted by patient weight. All participants may use compression stockings. Participants will be monitored for six weeks after delivery, coinciding with their usual postpartum care visit. The study measures the occurrence of symptomatic VTE, major and non-major bleeding events, treatment compliance, and mortality at six weeks and three months. Safety and clinical benefit are assessed, with ongoing follow-up to evaluate outcomes related to thromboprophylaxis in this population over the study duration.

Prevention of Postpartum Venous Thromboembolism in Women at Intermediate Risk