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.