Background and objective: Obstetric venous thromboembolism (VTE) poses a life-threating burden and 
it is one of the major causes of maternal morbidity and mortality with an increased incidence throughout 
the last decades. The objectives of this study were to assess the incidence of VTE, types of prophylaxis 
received and factors determining prophylaxis in women at VTE risk during pregnancy and puerperium at 
a tertiary hospital for one year. Methods: This is a prospective study that was carried out at Minia 
maternity university hospital, Egypt during the period from June 2018 to June 2019. The study included 
women attended the hospital at risk of VTE as per the RCOG guidelines. Full history, patient 
characteristics and VTE risk factors were assessed. Results: During the study period, a total of 901 
women attended the hospital and perceived at risk of VTE (298 cases during pregnancy and 603 cases 
during puerperium), about half of them were mild in intensity. They comprise 8.22% of the total 
deliveries during the study period (n=10956). About two-thirds of them (71.5%) had a caesarean delivery. 
Varicose veins were found in 209 cases (23.2%), previous VTE in 189 cases (21.0%), previous superficial 
vein thrombosis was recorded in 240 cases (26.6%) and previous arterial ischemic events in 83 cases 
(9.2%). The vast majority of patients (99.6%) received the pharmacological type of prophylaxis (55.6% of 
them received unfractionated heparin and the rest of them 43.9% received Aspirin). Only 6 cases 
developed VTE from the total included cases with an incidence of 0.55/1000 maternities (0.055%). 
Obesity (BMI >30 kg/m2) and cesarean delivery were significant factors that determine VTE prophylaxis 
with an odds ratio of 1.68 (95% CI, 1.20-2.35, p<0.01) and 2.05 (95% CI, 1.49-2.80, p<0.01), 
respectively. Conclusion: The incidence of women perceived at VTE risk during the study period was 
8.22% "which is lower than other studies", about half of them were mild in intensity. The risk of VTE 
was higher during the postpartum period than that during pregnancy. The incidence of VTE was 
0.55/1000 overall maternities (0.055%). The pharmacological type of prophylaxis was the predominant 
used type. Obesity and cesarean delivery were significant factors determining VTE prophylaxis. Further 
large-scale prospective studies with longer duration are warranted to confirm our findings.