Location
Suwanee, GA
Start Date
17-4-2026 12:00 PM
End Date
17-4-2026 1:00 PM
Description
Introduction
Venous thromboembolism (VTE) is a leading cause of pregnancy-related morbidity and mortality, accounting for approximately 9-10% of maternal deaths in the United States. Risk is highest in the early postpartum period due to physiologic hypercoagulability, venous stasis, endothelial injury, and reduced mobility. Postpartum patients with severe VTE requiring intensive care unit (ICU) admission represent a particularly vulnerable population, as critical illness-associated immobility, mechanical ventilation, and invasive monitoring contribute to functional decline and long-term disability. This review aimed to evaluate mobility-based functional recovery and structured discharge planning strategies for postpartum ICU patients with VTE to identify evidence-informed approaches that optimize maternal outcomes.
Methods
A structured narrative review of peer-reviewed literature was conducted, synthesizing obstetric guidelines, ICU early mobility and rehabilitation studies, and research on VTE-related functional outcomes. Functional recovery was assessed using validated ICU-specific measures, including the Physical Function in ICU Test-scored (PFIT-s) and the Functional Status Score for the ICU (FSS-ICU). Discharge planning approaches were analyzed using a multidisciplinary framework incorporating obstetrics, hematology, physical therapy, and primary care, with emphasis on anticoagulation management, bleeding risk, mechanical prophylaxis, and mobility barriers.
Results
Evidence from critical care populations demonstrates that early, progressive mobilization is associated with improved functional status at ICU and hospital discharge, reduced ICU-acquired weakness, and shorter lengths of stay. Among postpartum patients with VTE, delays in mobilization were most commonly related to anticoagulation initiating, concerns for postpartum hemorrhage, pain, deconditioning, indwelling devices, and restrictive bed rest orders. Reported outcomes included time to first ambulation, achievement of independent mobility, and physical therapy utilization. Discharge outcomes varied but consistently revealed gaps in functional readiness, anticoagulation education and monitoring, access to home services or durable medical equipment, and early readmission risk.
Conclusion
Early mobility interventions adapted from ICU rehabilitation protocols appear feasible and safe for postpartum patients with VTE when anticoagulation timing, bleeding risk, and neuraxial anesthesia considerations are carefully managed. Structured, multidisciplinary discharge planning that incorporates functional assessment, individualized anticoagulation strategies, and coordinated outpatient follow-up is essential to promote recovery, reduce long-term complications such as post-thrombotic syndrome, and support maternal self-care and infant care. Prospective studies are needed to establish standardized mobility protocols and to better characterize long-term functional and quality-of-life outcomes in this high-risk postpartum population.
Embargo Period
6-2-2026
Included in
From ICU to Home: Mobility-Based Recovery and Discharge Planning After Postpartum Venous Thromboembolism
Suwanee, GA
Introduction
Venous thromboembolism (VTE) is a leading cause of pregnancy-related morbidity and mortality, accounting for approximately 9-10% of maternal deaths in the United States. Risk is highest in the early postpartum period due to physiologic hypercoagulability, venous stasis, endothelial injury, and reduced mobility. Postpartum patients with severe VTE requiring intensive care unit (ICU) admission represent a particularly vulnerable population, as critical illness-associated immobility, mechanical ventilation, and invasive monitoring contribute to functional decline and long-term disability. This review aimed to evaluate mobility-based functional recovery and structured discharge planning strategies for postpartum ICU patients with VTE to identify evidence-informed approaches that optimize maternal outcomes.
Methods
A structured narrative review of peer-reviewed literature was conducted, synthesizing obstetric guidelines, ICU early mobility and rehabilitation studies, and research on VTE-related functional outcomes. Functional recovery was assessed using validated ICU-specific measures, including the Physical Function in ICU Test-scored (PFIT-s) and the Functional Status Score for the ICU (FSS-ICU). Discharge planning approaches were analyzed using a multidisciplinary framework incorporating obstetrics, hematology, physical therapy, and primary care, with emphasis on anticoagulation management, bleeding risk, mechanical prophylaxis, and mobility barriers.
Results
Evidence from critical care populations demonstrates that early, progressive mobilization is associated with improved functional status at ICU and hospital discharge, reduced ICU-acquired weakness, and shorter lengths of stay. Among postpartum patients with VTE, delays in mobilization were most commonly related to anticoagulation initiating, concerns for postpartum hemorrhage, pain, deconditioning, indwelling devices, and restrictive bed rest orders. Reported outcomes included time to first ambulation, achievement of independent mobility, and physical therapy utilization. Discharge outcomes varied but consistently revealed gaps in functional readiness, anticoagulation education and monitoring, access to home services or durable medical equipment, and early readmission risk.
Conclusion
Early mobility interventions adapted from ICU rehabilitation protocols appear feasible and safe for postpartum patients with VTE when anticoagulation timing, bleeding risk, and neuraxial anesthesia considerations are carefully managed. Structured, multidisciplinary discharge planning that incorporates functional assessment, individualized anticoagulation strategies, and coordinated outpatient follow-up is essential to promote recovery, reduce long-term complications such as post-thrombotic syndrome, and support maternal self-care and infant care. Prospective studies are needed to establish standardized mobility protocols and to better characterize long-term functional and quality-of-life outcomes in this high-risk postpartum population.