Acute postnatal venous thromboembolism (VTE) should be suspected during pregnancy in women with symptoms and signs consistent with possible VTE, particularly if there are other risk factors for VTE. During pregnancy, clinical assessment is even more unreliable since many of the symptoms and signs of VTE, such as leg swelling, chest pain and dyspnea, are commonly found in normal pregnancy. As a consequence, the accuracy of clinical diagnosis falls to about 8% for deep venous thrombosis (DVT) and to less than 5% for suspected pulmonary embolism (PE). Compression Duplex ultrasound of the entire proximal venous system is the optimal initial diagnostic test for DVT in pregnancy. For women on therapeutic anticoagulation, a planned delivery, either through induction of labour or elective caesarean section, allows accurate timing of events or minimizes the risk of the woman having to deliver on full anticoagulation.