Morbid obesity, is known to be associated with a high risk of VTE and, unfortunately, fixed doses of anticoagulant regimens may not provide optimal VTE prophylaxis in these patients especially after surgery.
Participants required surgical intervention in: general surgery, gynecology, bariatric surgery
Moderate, high, and very high risk for venous thromboembolism according to Caprin RAM
Participant is willing and able to give informed consent for participation in the study.
BMI ≥40kg/m2
Having any contraindication to LMWH, such as active bleeding, history of heparin-induced thrombocytopenia , baseline platelet count <75 × 108/μl, severe renal disease (glomerular filtration rate <30 ml/minute), severe liver disease, or uncontrolled hypertension (>200/120 mmHg)
Known hypersensitivity to unfractionated or LMWHs
On oral or parenteral anticoagulants within 5 days before surgery
Severe arterial hypertension