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Single Center Implementation of a Postpartum Pharmacologic Thromboprophylaxis Protocol
Ann M Bruno1, Amanda A Allshouse1, Christine M Warrick2
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah.
American Journal of Perinatology
|May 1, 2025
Summary
Implementing a postpartum venous thromboembolism (VTE) prevention protocol increased pharmacologic prophylaxis use. This change did not affect VTE or wound complication rates in postpartum patients.
Area of Science:
- Obstetrics and Gynecology
- Thrombosis and Hemostasis
- Public Health and Epidemiology
Background:
- Postpartum venous thromboembolism (VTE) is a significant cause of maternal morbidity.
- Effective prevention strategies are crucial for improving maternal outcomes.
- Standardized protocols can guide clinical practice and improve prophylaxis rates.
Purpose of the Study:
- To evaluate trends in pharmacologic prophylaxis frequency after implementing a postpartum VTE prevention protocol.
- To assess the association between protocol implementation and the incidence of VTE and associated complications.
Main Methods:
- A retrospective cohort study included 34,217 deliveries from 2015 to 2022.
- Patients were divided into preimplementation, initial protocol, and updated protocol periods.
- Outcomes included inpatient/outpatient prophylaxis, VTE, and wound complications, analyzed using logistic regression.
Main Results:
- Inpatient pharmacologic prophylaxis increased from 7.7% to 41.2% across protocol periods.
- Rates of VTE remained low (0.1-0.2%) and were not significantly different between periods.
- Wound complication rates also showed no significant difference across the protocol periods.
Conclusions:
- Single-center implementation of a postpartum prophylaxis protocol successfully increased pharmacologic prophylaxis use.
- The protocol did not lead to an increase in VTE or wound complications.
- This suggests that enhanced prophylaxis can be safely implemented without adverse effects on key outcomes.
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