Outcome comparison before & after new protocol of dvt chemoprophylaxis for cesarean section patients

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Conference Proceeding

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Obstet Gynecol


INTRODUCTION: Venous thromboembolism is one of the leading causes of maternal morbidity and mortality. After careful review of the available literature and discussion of the recommendations of multiple national organizations (American College of Obstetricians and Gynecologists, RCOG, American College of Chest Physicians, etc.), the Quality and Safety Committee at our hospital changed the protocol for VTE prophylaxis for obstetric patients. The new policy advocates a more aggressive VTE prophylaxis of 7500U heparin BID for all Cesarean section patients starting 12 hours post-operation. One year has passed since the implementation of the new chemoprophylaxis protocol and this comparison will allow us to analyze if the benefits outweigh the potential risks. METHODS: Retrospective chart review of one year before and one year implementation of new DVT chemoprophylaxis protocol for benefits and complications. Rates of wound infections, hematomas, dehiscence, ER visits, readmissions, DVT, and PE were studied. Initial records were collected from February 2015 through January 2016. 288 patients before protocol implementation and 296 patients after were studied. Cohorts were uniform in regards to age, race, BMI, gravidity, parity. RESULTS: No statistical significance noted at ± months with respect to wound complications, ED visits, readmission rates, DVT, or PE from before protocol implementation to after protocol implementation. CONCLUSION: Six month data suggest no statistical significance between the before and after protocol implementation groups. Additional data has been collected and is being analyzed out to the one year mark to determine if the policy change has benefited or adversely affected patients.



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