Background Venous thromboembolism (VTE) is the 3^rd leading cause of maternal death in the UK¹. In order to minimise VTE risk in the postnatal period, we introduced a new scoring system in June 2011, based on RCOG guidelines². Every woman’s VTE risk is scored, and those who meet predetermined criteria are discharged on a seven days (7/7) or six weeks (6/52) course of low molecular weight heparin (LMWH). There were concerns regarding patient compliance and so a survey was conducted to explore this.

Method Pharmacy data identified 113 postnatal women who were discharged in November 2011 on LMWH. A telephone survey in February 2012 assessed understanding of the need for LMWH, and compliance.

Results 52 women were successfully contacted: 29 had been prescribed a 7/7 course, and 23 a 6/52 course.

• 100% of women understood the need for LMWH.

• 96% of those on a 7/7 course completed all injections.

• Only 32% completed the 6/52 course.

We identified reasons for non-compliance and the destination of unused LMWH.

Conclusion Non-compliance has implications for both patient safety and cost. The survey highlighted the importance of effective patient education and identified a need for improved communication between primary and secondary care. A multidisciplinary approach, with all healthcare professionals emphasising the importance of LMWH in the postnatal period may improve long-term compliance. A patient information leaflet has since been introduced.

References

1. Centre for Maternal and Child Enquiries. Saving Mothers’ Lives: Reviewing Maternal Deaths to Make Motherhood Safer, 2006–2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. London: CMACE March 2011.

2. Royal College of Obstetricians and Gynaecologists. Green top Guideline No.37a: Reducing the risk of Thrombosis and Embolism during Pregnancy and the Puerperium. November 2009.