Risk Score of Lindqvist et al for Postpartum Thromboembolism

Factor V Leiden

heterozygous

1

Factor V Leiden

homozygous

3

prothrombin gene mutation

heterozygous

1

prothrombin gene mutation

homozygous

3

overweight in early pregnancy

BMI > 28 k per sq m

1

cesarean section

1

family history of thrombosis in a first degree relative < 60 years of age

1

age > 40

1

pre-eclampsia

1

abruptio placenta

1

protein S deficiency

2

protein C deficiency

2

immobilization

>= 1 week

2

lupus anticoagulant

2

cardiolipin antibodies

2

history of previous venous thrombo-embolic event (VTE)

4

history of repeated VTE

5

antiphospholipid syndrome (APS)

without prior VTE

4

antiphospholipid syndrome (APS)

with prior VTE

5

mechanical heart valve

5

need for continuous warfarin prophylaxis

5

antithrombin deficiency

5

other risk factor

1

0

none

none

1

5-fold increase

none

2

25 fold increase

short term (7 days) low molecular weight heparin after delivery or if immobilized

3

125 fold increase

6 week low molecular weight heparin starting within 4 hours after delivery

4

high (10% absolute)

antepartum prophylaxis AND continuing >= 6 weeks of low molecular weight heparin after delivery

5

very high (> 15% absolute)

high dose antepartum prophylaxis AND >= 12 weeks of low molecular weight heparin after delivery