Thromboprophylaxis in puerperium: an analysis of postnatal adherence to protocol in a small cohort of women at AMH

Introduction Venous Thromboembolism (VTE) is the leading cause of maternal mortality and morbidity. The risk is increased 60 fold during the first three months postpartum. If postnatal risk scores >2 patients should receive thromboprophylaxis for 7 days or 6-12 weeks depending on history. Aims To review postnatal thromboprophylaxis in high risk women who have recently delivered and are at increased risk of VTE. Methodology Retrospective case note analysis of 50 women from mid September to mid November 2011. Results In the intermediate risk group, there were 3 women with BMI > 40, 3 were intravenous drugs (IVD) abusers and 25 women had emergency LSCS. Among the group with 2 or more risk factors, 7 were aged more than 35 years with other associated risk factors such as 2 with BMI>30, 1 smoker, 1 with prolonged labour and 3 had elective LSCS. There were 7 women with BMI>30 with associated risks such as 1 women was a Para 3, two had prolong labour and 4 had elective LSCS. There was 5 smokers of which 4 had elective LSCS and 1 was a Para 3. Thromboprophylaxis was received by 39 women for 2 days, 8 women received for 3 days and three women for 4 days-this was due to hospital stay for delayed neonatal discharge. In total only 2 patients had a combination of TEDS and Dalteparin. Conclusion Thromboprophylaxis is an integral part of postnatal care and we should be more vigilant in this regard.