Published thromboprophylaxis checklists, rebuilt as interactive tools.
Our guidelines still arrive on paper. The RCOG risk assessment is a printed table of 28 risk factors with a tick column, a score column and a box marked TOTAL. The SMFM checklist is a one-page PDF, meant to be referenced during the cesarean sign-out. Who carries these pages? Who adds up the score correctly at 3 a.m., remembers which factors count only after birth, and turns a spinal placement time into the earliest safe heparin dose?
SMFM answers part of that question itself. Its checklist warns that relying on memory alone to guide prophylaxis "is likely to result in errors." A sheet of paper does not remember either. It cannot add, cannot stop two choices that exclude each other, cannot switch thresholds after birth, and cannot tell a clinician that a rule on another page overrides the score.
Paper is out. Every checklist on this site is interactive. Each tool applies one published guideline exactly as written, does the arithmetic, applies the timing rules, and labels every recommendation with the line of the source it comes from. Where a source document is ambiguous or contradicts itself, the tool says so instead of guessing.
The question each tool answers is the same: who should receive low molecular weight heparin, when, and for how long. Heparin prevents clots, but it also brings injections, bleeding risk and anesthetic timing constraints. The guidelines answer that question differently. The RCOG scores risk across pregnancy and the puerperium; SMFM, after cesarean, asks about prior VTE, thrombophilia and severe obesity. Side by side, the differences become visible.
Each tool runs entirely in your browser. Nothing you enter is stored or sent anywhere.
The same woman can receive no LMWH under one guideline and six weeks under the other. The differences below are read directly from the two source documents.
| RCOG GTG 37a position statement | SMFM checklist (Consult Series #51) | |
|---|---|---|
| Scope | Antenatal and postnatal, all modes of birth, any admission | After cesarean only |
| Method | Weighted point score. Thresholds: 4 (antenatal, first trimester), 3 (from 28 weeks), 2 (postnatal) | Categories: prior DVT/PE, any thrombophilia, BMI ≥ 40 combined with either |
| Cesarean alone | Cesarean in labour scores 2, which alone meets the postnatal threshold for LMWH (at least 10 days) | Sequential compression devices only |
| Low-risk thrombophilia, no VTE | 1 point; 6 weeks only with a first-degree family history | LMWH for 6 weeks |
| Obesity alone | BMI 40–49 scores 2; BMI ≥ 50 means LMWH in pregnancy and for 6 weeks postpartum | No LMWH at any BMI without prior VTE or thrombophilia |
| Infection, surgery, immobility | 4 points each; continue LMWH while present and for 7 days after | Not listed as risk factors |
| Dose | Weight bands: 40, 60 or 80 mg enoxaparin daily; 0.6 mg/kg/day at 170 kg or more | Enoxaparin 40 mg daily; 40 mg every 12 hours if BMI ≥ 40 with VTE or thrombophilia; individualized for combinations |
| Anesthesia timing | Not addressed | Explicit intervals after general and neuraxial anesthesia |