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PM.46 Reducing the Risk of Thrombosis and Embolism During the Puerperium: How Compliant Are Patients with Thromboprophylaxis Treatment?
  1. CE Hordern,
  2. CW Bircher,
  3. EC Prosser-Snelling,
  4. RP Smith
  1. Norfolk and Norwich University Hospital, Norwich, UK

Abstract

Introduction Our unit adopted guidelines incorporating the RCOG advice on reducing the risk of thromboembolism in pregnancy and the pureperium1 in 2010. All women with 2 or more risk factors are offered a once daily 7 day course of low molecular weight heparin (LMWH) injections immediately following delivery. A previous study in our unit suggested that 41% of patients would meet the criteria for postnatal thromboprophylaxis2.

Methods Patients were recruited in the antenatal clinic or on the postnatal ward. They were contacted after delivery by telephone and asked a series of questions related to their compliance with thromboprophylaxis.

Results Of 67 patients only 56 (84%) had completed the full course.

The most common reasons for not completing were: didn’t feel it was helping; bruising or wound complications; dislike of needles and forgetting.

Thirteen (19%) did not feel they received enough information regarding thromboprophylaxis.

Regarding the injections: 40 (61%) self-injected; 22 (33%) asked family; 4 (6%) asked health professionals.

Sixty two (93%) would take thromboprophylaxis if indicated in a future pregnancy.

Conclusions Reported patient compliance with 7 days of postnatal thromboprophylaxis is high. Most patients are prepared to self-inject although a substantial number required help to administer the injections. The majority would accept the medication if required in a future pregnancy. Some did not feel they had adequate information and this could be addressed in our unit.

References

  1. Royal College of Obstetricians and Gynaecologists Green-Top Guideline No. 37a. Reducing the risk of thrombosis and embolism during pregnancy and the puerperium. London: Royal College of Obstetricians and Gynaecologists, 2009.

  2. Revell BJ, Smith RP. Thrombosis and embolism in pregnancy and the puerperium, reducing the risk: what proportion of patients reach the threshold for thromboprophylaxis? Obstetric Medicine. 2010; 4: 12–14.

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