A lengthy guideline has been published by ACOG, on the prevention and treatment of VTE during pregnancy. In short, they conclude that for suspected PE, either V/Q scan or CT PE are acceptable diagnostic studies during pregnancy, and that for prevention and treatment, both heparins and low-molecular weight heparins are acceptable. Those with high-risk thrombophilias should be treated with prophylaxis during pregnancy and postpartum. They recommend cessation of anti-coagulants for delivery / epidurals, with resumption 6-12 hours after delivery, or 12 hours after epidural removal (guidelines)
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.