Pregnancy and VTE Information for Healthcare Professionals

Thrombosis UK is saddened to see from the latest MBRRACE report, covering maternal deaths between 2022 and 2024, that blood clots remain the leading direct cause of maternal death in the UK.

Since the previous report, important progress has been made. Working with NHS England, Thrombosis UK has supported the development of the Early Pregnancy Risk Assessment Tool, which helps women and healthcare professionals identify clotting risks before formal maternity booking.

However, the charity is concerned that updated guidance from the Royal College of Obstetricians and Gynaecologists, recommended following the 2024 MBRRACE report, has not yet been published. Thrombosis UK urges the College to prioritise the publication of updated recommendations to help ensure that pregnant women receive the best possible care.

Thrombosis UK remains committed to campaigning for improved awareness, prevention, research, and care to reduce the number of families affected by preventable blood clot-related maternal deaths.

Guidance for medial professionals on the prevention of blood clots during pregnancy and after birth is being updated by the Royal College of Obstetricians and Gynaecologists (RCOG). The current guidance was published in 2015 and is now more than a decade old. We do not believe it is acceptable for updated guidance to have taken this long, given the importance of preventing blood clots during pregnancy and after birth.

Thrombosis UK is calling for the updated guidance to be completed and published as soon as possible. Together with Alicia Kearns MP, we have raised the importance of this with the RCOG President and will continue to press for the new guidance to be published without further delay.

In the meantime, RCOG has published an interim statement to support greater consistency between the existing 2015 guidance and the NHS England/Thrombosis UK early pregnancy risk assessment tool.

The interim statement includes updated advice on the dosing of low molecular weight heparin (LMWH), bringing this in line with the approach used in the Thrombosis UK early pregnancy tool. It also adds a BMI of more than 50 to the risk assessment tool, with this risk factor scoring four points throughout pregnancy.

We welcome these interim changes, which should help improve consistency in practice. However, they are not a substitute for comprehensive, up-to-date guidance. We will continue to press for the updated guidance to be completed and published as a matter of urgency.

At Thrombosis UK, we were delighted to see Alicia Kearns MP raise the vital issue of blood clot prevention and care during pregnancy through a series of detailed written parliamentary questions. Ensuring that women receive appropriate risk assessment, timely diagnosis, and effective prevention measures is essential, given that blood clots remain a leading cause of maternal death.

As an organisation dedicated to improving awareness and patient outcomes, we welcomed the opportunity for greater parliamentary scrutiny of this important issue. However, we were disappointed by the responses provided, which we feel did not fully address the challenges faced by women at risk of thrombosis during pregnancy and the postnatal period.

We remain committed to working with policymakers, healthcare professionals, and patients to improve awareness, prevention, and standards of care. We would welcome more detailed responses from Yvette Cooper MP and her new team. You can read the parliamentary questions and responses in full here: https://members.parliament.uk/member/4805/writtenquestions.

Alicia Kearns MP said in a debate on healthcare in pregnancy following the Amos and Ockendon reports, on Tuesday 30^th June

“This week last year, I had multiple pulmonary emboli only a few weeks after giving birth. I am very grateful to Dr Laura Stephens, who saved my life and then was punished for ordering the test which found the emboli. Blood clots are the No. 1 cause of death in pregnant and post-partum women, and yet there is not a word about their risk in any pregnancy pack given out in this country. The national action plan will fail if it does not tackle blood clots as the No. 1 cause of maternal deaths. Will the Health Secretary kindly meet me and work with me, so that together we can save lives?”

According to the latest official data, there were 252 maternal deaths from 2022 to 2024, 20% higher than the rates from 2009 to 2011. The NHS has announced every maternity service in England will have to upend clinical standards to reduce the number of women who die during or after pregnancy.

This leaflet, co-created by Thrombosis UK, provides information on blood thinners, also known, as anticoagulants, to people who have or are considering a mechanical/ metallic heart valve and are either pregnant or thinking about a pregnancy.