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Advanced Obstetrics guide

Venous Thrombosis in Pregnancy and After Birth

Risk assessment, prevention and urgent symptoms of deep-vein thrombosis and pulmonary embolism during pregnancy and postpartum.

Specialist-depth overview
10–12 min readUpdated 21 July 2026Evidence-informed patient education

Pregnancy and the weeks after birth increase the risk of venous thromboembolism, which includes deep-vein thrombosis (DVT) and pulmonary embolism (PE). Individual risk assessment helps identify who may benefit from compression measures, mobility advice or anticoagulant injections.

Risk is reassessed during pregnancy, hospital admission, birth and the postnatal period.
One-sided leg swelling or sudden breathlessness requires urgent assessment, not routine review.
Preventive anticoagulation is based on the total risk profile rather than one factor alone.
Original educational diagram for Venous Thrombosis in Pregnancy and After Birth
Original educational diagram created for this topic. It explains the care pathway visually and is not a diagnostic image.

Risk factors and reassessment

Previous thrombosis, thrombophilia, higher BMI, immobility, severe infection, hyperemesis, multiple pregnancy, pre-eclampsia, caesarean birth and postpartum haemorrhage can affect risk. The score can change as pregnancy progresses or after admission.

Prevention

Measures include hydration, mobilisation, mechanical compression and low-molecular-weight heparin when indicated. A plan should cover dose timing around labour, regional anaesthesia and surgery, as well as duration after birth.

How DVT and PE are investigated

Symptoms are assessed urgently. Ultrasound is commonly used for suspected leg DVT, while chest imaging may be needed for suspected PE. Pregnancy should not prevent appropriate diagnostic imaging when a serious clot is possible.

Anticoagulation and follow-up

Treatment usually continues for a defined period and requires planning for birth, breastfeeding, future contraception and later pregnancies. Patients should know whom to contact before stopping or changing anticoagulation.

Questions worth discussing at your consultation

  • What factors place me in a higher-risk group?
  • Do I need preventive heparin, and for how long?
  • How will injections be managed around labour or caesarean birth?
  • Which symptoms require emergency care?
When to seek urgent careCall emergency services for sudden unexplained breathlessness, chest pain, coughing blood, collapse or severe palpitations. Seek same-day assessment for one-sided leg pain, swelling, warmth or redness.
Medical note: This page is educational and is structured to support a specialist consultation. Diagnosis, investigations and treatment must be individualised. It has not been presented as a substitute for an examination or emergency assessment.