Background: Pregnancy is associated with 4-5 times increased risk of venous thromboembolism (VTE). Lack of consensus regarding initiation of postpartum VTE prophylaxis resulted in development and implementation of a new guideline at the Women’s and Children’s Hospital. An audit was conducted to ascertain compliance and efficacy of the implemented guideline.
Method: A retrospective audit of 197 women who gave birth between September and December 2013 was conducted. Relevant de-identified patient data was collected and analysed for compliance to the guideline. VTE incidence data of obstetric patients over six months was contrasted pre- and post- guideline implementation. Incidence post implementation was assessed against current guideline recommendations.
Results: Compliance to the postpartum VTE prophylaxis guideline was 89%. Compliance to recommendations for initiation of prescribing pharmacological prophylaxis was 46%. Pre-guideline implementation, no VTE was observed in any postpartum patient. Following implementation two women developed VTE however both failed to meet inclusion criteria for prophylaxis.
Conclusions: Compliance to the postpartum VTE prophylaxis guideline is satisfactory although initiation of prescribing pharmacological prophylaxis is sub-optimal. It is recommended further education be undertaken with the obstetrics department to improve VTE prophylaxis initiation and further studies undertaken to draw conclusions on efficacy.