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Thromboprophylaxis for caesarean section--how can uptake and coverage be improved?
1Department of Obstetrics and Gynaecology, Hull Royal Women and Children's Hospital, Hull, UK. gidiri@aol.com
Summary
Most women need thromboprophylaxis after caesarean section, but protocols are not always followed. Universal prophylaxis with low molecular weight heparin could improve care for at-risk patients.
Area of Science:
- Obstetrics and Gynecology
- Thrombosis Research
- Patient Safety
Background:
- Caesarean section increases the risk of thromboembolism.
- Adherence to thromboprophylaxis protocols after caesarean section is crucial for patient safety.
Purpose of the Study:
- To determine the proportion of patients requiring thromboprophylaxis post-caesarean section.
- To evaluate adherence to local thromboprophylaxis protocols.
- To assess the effectiveness of a checklist in improving protocol adherence.
Main Methods:
- Retrospective audit of 200 patients undergoing caesarean section.
- Evaluation of prophylaxis requirements, treatment appropriateness, and omissions.
- Assessment of adherence to a risk assessment protocol and checklist usage.
Main Results:
- 84.5% of women had at least one risk factor for thromboembolism.
- Checklist use did not improve appropriate thromboprophylaxis or reduce inappropriate use.
- Checklists were used appropriately in only 54% of cases.
Conclusions:
- Current protocols show suboptimal adherence for thromboprophylaxis after caesarean section.
- Universal prophylaxis with low molecular weight heparin is suggested to prevent missed at-risk patients.