Abstract
Background Management of pregnant women at risk of venous thromboembolism(VTE) and placental vascular complications (PVCs) remains complex. Guidelines do notdefinitively specify optimal strategies.Objective Our objective was to evaluate the impact of employing risk score-drivenprophylaxis strategies on VTE and PVC rates in at-risk pregnant women.Materials and Methods This study, conducted in 21 French maternity units, compared VTE and PVC rates before and after implementation of a risk scoring system todetermine prophylactic strategies.Results A total of 2,085 pregnant women at risk of VTE or PVC were enrolled. Vascularevents occurred in 190 (19.2%) patients before and 140 (13.0%) after implementation of riskscore-driven prophylaxis (relative risk [RR] ¼ 0.68 [0.55; 0.83]). The incidence of deep veinthrombosis during pregnancy was reduced (RR ¼ 0.30 [0.14; 0.67]). PVC comprised mainlypre-eclampsia,occurring in79patientsbeforeand42patients afterrisk score implementation(RR ¼ 0.52 [0.36; 0.75]). Post-partum haemorrhage occurred in 32 patients (3.2%) beforeand 48 patients (4.5%) after risk score implementation (RR ¼ 1.38 [0.89; 2.13], p ¼ 0.15).Conclusion Use of a simple risk scoring system, developed by experts in VTE and PVCresearch to guide prophylaxis, reduced the risk of thrombotic events during pregnancywithout any significant increase in bleeding risk.