Implementation of thromboprophylaxis guidelines.
Venous thromboembolism (VTE) remains one of the leading direct causes of maternal death. Risk factors for VTE and prophylaxis guidelines have been highlighted by the Royal College of Obstetricians and Gynaecologists (RCOG). A cross sectional study was completed in Cork University Maternity Hospital (CUMH) to determine pattern of VTE risk and compliance with 2004 RCOG guidelines. 364 women's charts were reviewed. Forty percent (n = 145) were at risk for VTE, 69% (n = 100) of these received thromboprophylaxis but only 54% (n = 54) received the correct weight adjusted dose. Three of four morbidly obese women in this study received recommended thromboprophylaxis but none at the appropriate dose. Only 67% (n = 245) had a recorded body mass index (BMI). Increased BMI is a significant risk factor for VTE and should be measured and recorded at the booking visit. Awareness of the risks for VTE and the need for appropriate dosing should be improved.
Anu Research Centre, UCC Department of Obstetrics and Gynaecology, Cork University Maternity Hospital, Wilton, Cork. alisoncregan@yahoo.com
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Cregan
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Higgins
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O'Shea
D000925:Anticoagulants / Q000627:therapeutic use*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006785:Hospitals, University; D006801:Humans; D009765:Obesity / Q000150:complications; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000517:prevention & control*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000517:prevention & control*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight