Physiological changes in pregnancy makes the pregnancy is in hypercoagulable state. The risk further increase as the pregnant women had other associated medical comorbidity. The problem statement of this paper has commenced when recent 2016/2017 statistic in Malaysia revealed that the principal cause of maternal death in pregnancy is Venous Thromboembolism (VTE) particularly Pulmonary Embolism (PE). Thus, it is crucial to prioritize on prevention (al-wiqayah) before it happens. The treatment of obstetrical VTE both prophylaxtic or treatment dose with anticoagulant agent of Low Molecular Weight Heparin (LMWH) in specific (Enoxaparin Sodium) which is porcine based medicine is the main issue to be highlighted today. The objectives of this research are to explore the legitimacy of Clexane as preventive medicine of VTE during pregnancy and puerperium which is being used in Malaysian government hospitals as permitted by Malaysia Ministry of Health (MOH). Secondly, to harmonize the decisions between authorities, including Malaysia National Fatwa Council (MNFC), JAKIM and MOH decision regarding the prohibition of Clexane usage among Muslims. This qualitative research of methodology is utilizing interview and document review analysis. The finding of this research is the new dimension of fatwa is proposed for practicality in Malaysian hospitals which weighing al-hajah al-shariah can be a legal parameter in determining Islamic ruling. The need (al-hajah) to have preventive medicine eventhough it presents as porcine based medicine which declared by Islamic Jurisprudence could appear as a new contemporary ijtihad in epistemic of fiqh al-waqi’ in Malaysia nowadays. In fact, this decision will parallize the stance between JAKIM, MNFC and MOH regarding the practice that contrast with fatwa issued.

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