VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.
Research article published in Chest (2012)
Abstract
BACKGROUND: The use of anticoagulant therapy during pregnancy is challenging because of the potential for both fetal and maternal complications. This guideline focuses on the management of VTE and thrombophilia as well as the use of antithrombotic agents during pregnancy. METHODS: The methods of this guideline follow the Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement. RESULTS: We recommend low-molecular-weight heparin for the prevention and treatment of VTE in pregnant women instead of unfractionated heparin (Grade 1B). For pregnant women with acute VTE, we suggest that anticoagulants be continued for at least 6 weeks postpartum (for a minimum duration of therapy of 3 months) compared with shorter durations of treatment (Grade 2C). For women who fulfill the laboratory criteria for antiphospholipid antibody (APLA) syndrome and meet the clinical APLA criteria based on a history of three or more pregnancy losses, we recommend antepartum administration of prophylactic or intermediate-dose unfractionated heparin or prophylactic low-molecular-weight heparin combined with low-dose aspirin (75-100 mg/d) over no treatment (Grade 1B). For women with inherited thrombophilia and a history of pregnancy complications, we suggest not to use antithrombotic prophylaxis (Grade 2C). For women with two or more miscarriages but without APLA or thrombophilia, we recommend against antithrombotic prophylaxis (Grade 1B). CONCLUSIONS: Most recommendations in this guideline are based on observational studies and extrapolation from other populations. There is an urgent need for appropriately designed studies in this population.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.
Why This Matters for Hirudotherapy
This practice guideline provides evidence-based recommendations for the management of venous thromboembolism (VTE), thrombophilia, and the use of antithrombotic agents during pregnancy. It recommends low-molecular-weight heparin over unfractionated heparin for prevention and treatment of VTE in pregnant women (Grade 1B), continuation of anticoagulants for at least six weeks postpartum for acute VTE (Grade 2C), and combined prophylactic heparin with low-dose aspirin for women with antiphospholipid antibody syndrome and a history of three or more pregnancy losses (Grade 1B). The guideline notes that most recommendations are based on observational studies and extrapolation from other populations. The abstract contains no mention of leeches, hirudotherapy, hirudin, or the leech secretome, so its relevance to the American Society of Hirudotherapy is not supported by this article.
Citation
VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.
Bates et al. · Chest, 2012
Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026