American Board of Internal Medicine (ABIM) Certification Practice Exam

For pregnant women undergoing treatment for venous thromboembolism, for how long should anticoagulants be continued postpartum?

1. At least 1 month

2. At least 6 weeks

3. For the duration of breastfeeding

4. For a minimum of 2 months

The correct answer is: At least 6 weeks

The recommendation to continue anticoagulants for at least 6 weeks postpartum is rooted in the increased risk of venous thromboembolism (VTE) during the postpartum period. After delivery, especially in the first 6 weeks, women remain at heightened risk due to various physiological changes and factors, such as decreased mobility, the hypercoagulable state of pregnancy, and potential operative deliveries – all contributing to the likelihood of clot formation. This period is critical because it's when most thromboembolic events can occur. Continuing anticoagulation for at least 6 weeks postpartum provides a safeguard against the potential development of VTE, significantly reducing the chance of incidents during this vulnerable time. This duration balances the need for protection while considering the risks versus benefits of prolonged anticoagulation and its potential impact on breastfeeding and maternal health. Though some options might suggest different durations or conditions, the 6-week period aligns with current clinical guidelines and expert consensus on maintaining adequate protection against VTE in the postpartum timeframe.