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Published on: November 26, 2013

Implementation of thromboprophylaxis guidelines

A Cregan1, J R Higgins, S O'Shea

  • 1Anu Research Centre, UCC Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Wilton, Cork. alisoncregan@yahoo.com

Irish Medical Journal
|August 20, 2013
PubMed

Insights

Maternal deaths from venous thromboembolism (VTE) are high. While many at-risk women received prophylaxis, incorrect dosing was common, highlighting a need for improved VTE risk assessment and management in obstetrics.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal Health
  • Thrombosis Research

Background:

  • Venous thromboembolism (VTE) is a significant cause of maternal mortality.
  • Royal College of Obstetricians and Gynaecologists (RCOG) has issued guidelines for VTE risk factors and prophylaxis.
  • Cork University Maternity Hospital (CUMH) aimed to assess VTE risk and guideline adherence.

Purpose of the Study:

  • To determine the pattern of VTE risk among pregnant women at CUMH.
  • To evaluate compliance with the 2004 RCOG VTE prophylaxis guidelines.
  • To identify areas for improvement in VTE prevention strategies.

Main Methods:

  • A cross-sectional study involving the review of 364 women's medical charts.
  • Analysis of VTE risk factors, thromboprophylaxis administration, and dosage accuracy.
  • Assessment of body mass index (BMI) recording practices.

Main Results:

  • 40% of women were identified as being at risk for VTE.
  • 69% of at-risk women received thromboprophylaxis, but only 54% received the correct weight-adjusted dose.
  • Morbidly obese women frequently received incorrect doses, and BMI was not consistently recorded.

Conclusions:

  • There is a need to improve awareness of VTE risks and appropriate dosing in obstetric care.
  • Consistent measurement and recording of BMI at booking visits are crucial for VTE risk assessment.
  • Enhanced adherence to VTE prophylaxis guidelines is necessary to reduce maternal morbidity and mortality.

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