Prophylaxis

• Anticoagulation is not recommended for asymptomatic patients.

• Prophylaxis in pregnancy depends on family history and nature of thrombophilic defect. For management of pregnant patient with history of VTE, prophylactic heparin has been successful in subsequent preg-

398 nancies.

• High risk situations e.g. surgery, trauma, should be identified and covered with prophylactic SC heparin. Dose will depend on the thrombotic risk. ffl p588

• Patients must be informed of factors that increase thrombotic risk and given an information sheet.

• Patients with an identified thrombophilic defect should be advised of increased risk of VTE with the OCP or HRT.

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