Venous thromboembolism bundle: Risk assessment and prophylaxis for obstetric patients.

@article{Friedman2016VenousTB,
  title={Venous thromboembolism bundle: Risk assessment and prophylaxis for obstetric patients.},
  author={Alexander M. Friedman and Mary E. D'Alton},
  journal={Seminars in perinatology},
  year={2016},
  volume={40 2},
  pages={
          87-92
        }
}
While venous thromboembolism (VTE) is a leading cause of severe maternal morbidity and mortality, maternal death from VTE is amenable to prevention. Thromboprophylaxis is the most readily implementable means of systematically reducing the maternal death rate, and protocols that identify at-risk women have led to a significant reduction in maternal deaths from VTE. Strategies to prevent VTE require minimal resources. A multidisciplinary working group convened as part of American Congress of… 
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Utilization of venous thromboembolism prophylaxis in American hospitalized pregnant women undergoing cesarean section
TLDR
A large population of c-section patients fit the SMI criteria for pharmacologic VTE prophylaxis but did not receive it, and a 0.49% rate of VTE was observed, slightly higher than the nationally reported average rate of 0.3%.
Implementing Obstetric Venous Thromboembolism Protocols on a Statewide Basis: Results from New York State's Safe Motherhood Initiative.
TLDR
While adoption of the SMI VTE bundle occurred at a majority of centers across New York, uptake was less likely at low-acuity centers, and adoption was associated with implementation of recommended practices.
Opportunities for hospitals, hospital systems and leadership to improve VTE prophylaxis.
TLDR
Changes in obstetric health care over the last ten years implemented to prevent VTE and its related morbidity are reviewed and opportunities for hospitals and hospital systems to improve VTE prophylaxis are examined.
A critical analysis of prophylaxis to avoid venous thromboembolism after cesarean delivery
TLDR
The results of the study suggest that the majority of pregnant women should be given VTE prophylaxis after cesarean delivery.
Evaluation of a Risk-Stratified, Heparin-Based, Obstetric Thromboprophylaxis Protocol.
TLDR
Risk-stratified heparin-based thromboprophylaxis in a general obstetric population was associated with increased wound and bleeding complications without a complementary decrease in postpartum VTE.
SBA 2020: Regional anesthesia guideline for using anticoagulants update
Thromboprophylaxis during the Pregnancy-Puerperal Cycle - Literature Review.
TLDR
There are some gaps in the research, and clinical studies with appropriate methodology are needed to support decisions made regarding the risk of thromboembolism in the perigestational period.
Applying Patient Safety to Reduce Maternal Mortality.
Neuraxial Anesthesia in Obstetric Patients Receiving Thromboprophylaxis With Unfractionated or Low-Molecular-Weight Heparin: A Systematic Review of Spinal Epidural Hematoma
TLDR
It is encouraging that this comprehensive search did not identify a single case of SEH in an obstetric patient receiving thromboprophylaxis and neuraxial anesthesia, and optimal care of obstetric patients depends on multidisciplinary planning of anticoagulation dosing to facilitate neuraxia anesthesia and thoughtful weighing of the relative risks and benefits of providing versus withholding neuraxIAL in favor of general anesthesia.
Immediate postpartum management of patients with severe hypertensive disorders of pregnancy: pathophysiology guiding practice.
  • J. Hogg, Jamie Szczepanski, Charlene H. Collier, J. Martin
  • Medicine
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2020
TLDR
A concise summary of the core pathophysiologic issues, practice principles and clinical interventions which are foundational for physicians providing immediate postpartum care for patients with severe pregnancy-related hypertension are constructed.
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