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Postpartum Thromboembolism Prophylaxis during Delivery Hospitalizations
Audrey A Merriam1,2, Yongmei Huang1, Cande V Ananth1,2
1Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, New York.
American Journal of Perinatology
|March 14, 2018
Summary
Venous thromboembolism (VTE) prophylaxis use during delivery hospitalizations declined slightly for cesarean deliveries and remained low for vaginal deliveries. Significant hospital variation exists in VTE prophylaxis practices, impacting maternal safety.
Area of Science:
- Obstetrics and Gynecology
- Thrombosis and Hemostasis
- Healthcare Quality and Safety
Background:
- Venous thromboembolism (VTE) is a significant risk for women during delivery hospitalizations.
- Current clinical guidelines recommend VTE prophylaxis for certain patient populations.
Purpose of the Study:
- To evaluate trends in VTE prophylaxis administration during vaginal and cesarean delivery hospitalizations in the US.
- To assess variations in VTE prophylaxis use across different hospitals.
Main Methods:
- Retrospective analysis of an administrative database from January 2011 to March 2015.
- Inclusion of women hospitalized for vaginal or cesarean delivery.
- Categorization of prophylaxis as pharmacologic, mechanical, or both.
Main Results:
- Cesarean VTE prophylaxis decreased from 50.3% in 2011 to 47.7% in 2015 (p < 0.01).
- VTE prophylaxis was used in only 2.9% of vaginal deliveries.
- One-third of hospitals used VTE prophylaxis in less than 20% of cesarean deliveries.
Conclusions:
- While some hospitals adhere to best practices, others do not consistently provide cesarean VTE prophylaxis.
- Reducing variation in VTE prophylaxis care quality is crucial for enhancing maternal safety.
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