title: Practice patterns and preferences of obstetricians and gynecologists regarding thromboprophylaxis at the time of Cesarean section.
abstract: OBJECTIVE
  Our survey aimed to identify knowledge and application of guidelines in the United States by assessing practicing obstetricians and gynecologists (OBGYN) use of thromboprophylaxis, preferred methods and whether their type of practice influenced their choices.
  
  
  METHODS
  A cross-sectional survey of fellows of the American College of Obstetricians and Gynecologists (ACOG) was performed. A 21-item paper and electronic questionnaire was sent to each participant. A total of three mailings were carried out.
  
  
  RESULTS
  In total, 400 OBGYN were invited to participate. Questionnaires were returned by 209 (52.3%), 157 (75.1%) of whom provided prenatal care within the last year. All respondents used at least one method of thromboprophylaxis routinely. About 92.4% used pneumatic compression devices. An equal proportion used unfractionated heparin and low molecular weight heparin routinely (17.8%). About 19.1% routinely used combination prophylaxis. In total, 77.1% (n = 121) used the ACOG guidelines. Local hospital guidelines were referenced by 38.2% (n = 60). Other guidelines referenced were the ACCP guideline (n = 34, 21.7%) and several international guidelines (n = 5, 3.3%).
  
  
  CONCLUSIONS
  Awareness of the risk of thromboembolism around delivery by cesarean section is high among OBGYN practitioners. Broadening guidelines to encompass all deliveries, not only cesareans, with a focus on identifying the patient at risk, would likely be successful.
authors.affiliation: Department Obstetrics and Gynecology, Rotunda Hospital , Dublin 1 , Ireland .
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Donnelly
authors.forename: Greta B
authors.initials: GB
authors.lastname: Raglan
authors.forename: Clarissa
authors.initials: C
authors.lastname: Bonanno
authors.forename: Jay
authors.initials: J
authors.lastname: Schulkin
authors.forename: Mary E
authors.initials: ME
authors.lastname: D'Alton
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002585:Cesarean Section / Q000379:methods*; D018890:Chemoprevention / Q000706:statistics & numerical data; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D048228:Intermittent Pneumatic Compression Devices; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011322:Primary Prevention / Q000379:methods*; D011795:Surveys and Questionnaires; D054556:Venous Thromboembolism / Q000517:prevention & control*
chemical_list: D006495:Heparin, Low-Molecular-Weight; D006493:Heparin
keywords: Cesarean delivery; guidelines; heparin; pneumatic compression devices; thromboprophylaxis