04/09/2026
The RCOG has published a position statement on reducing the risk of venous thromboembolism (VTE) during pregnancy and the puerperium, bringing it in line with NHS England's Maternal Care Bundle (MCB). The College is currently undertaking a full update to Green-top Guideline 37a; this is being led by the 37a guideline developer team.
Venous thromboembolism remains the leading direct cause of maternal death in the UK during pregnancy and up to six weeks postpartum, according to recent MBRRACE-UK reports.
While the full update is in development, we've published a position statement (interim clinical guidance) to support clinicians now which clarifies:
◾First trimester (or the first antenatal booking appointment), miscarriage or termination → follow NHS England's Maternal Care Bundle
◾After the first antenatal booking appointment - including labour, birth and the six weeks postpartum → continue following current RCOG guidance, with key updates:
• A revised VTE risk assessment
• Updated weight-based LMWH dosing
• A new threshold offering thromboprophylaxis for women with a BMI ≥50 kg/m², throughout pregnancy and for six weeks postpartum
We encourage all clinicians to access the full statement with details of the changes here: https://ow.ly/JnJR50ZIUhi