Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about venous thromboembolism in pregnancy. And you can find written notes on this topic

at zero to finals.com slash VTE or in the anteninatal care section of the zero definals, obstetrics and

gynecology book. So let's get straight into it. Venus thromboembolism or VTE is a common and

potentially fatal condition. It involves blood clots or thrombosis developing in the circulation.

Thrombosis occurs as a result of stagnation of blood and hypercoagulable states such as pregnancy.

A hypercoagulable state means a state in which blood clots are more likely to develop.

When a thrombosis develops in the venous circulation, it's called a deep vein thrombosis, or DVT.

This thrombosis can mobilize or move, which is called embolization, from the deep veins and travel up to the lungs,

where it becomes lodged in the pulmonary arteries. A blood clot in the pulmonary arteries

blocks blood flow to the related areas of the lungs, and this is called a pulmonary embolism, or PE.

Pulmonary embolism is a significant cause of death in obstetrics.

The risk is significantly reduced with venous thromboembolism prophylaxis.

The risk is highest in the postpartum period shortly after giving birth.

Let's talk about the risk factors. There's a long list of risk factors for venous

thrombo embolism in pregnancy, including smoking, parity of more than or equal to three,

age above 35 years, a BMI above 30, reduced mobility,

multiple pregnancies, for example twins, preeclampsia, significant varicous veins,

a family history of venous thrombembolism, thrombophilia, and an IVF pregnancy.

The RCOG guidelines from 2015 advise starting prophylaxis from 28 weeks gestation if there are

three risk factors, or from the first trimester, if there are

four or more of these risk factors. There are some additional scenarios where prophylaxis

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