Abstract
Study design: The present study is a retrospective review of 500 consecutive births at one academic institution before and after implementation of a uniform thromboprophylaxis policy with heparin for all cesarean deliveries. An “opt-out” policy for ordering physicians was implemented by automatically defaulting to order heparin in the electronic order set used after cesarean delivery.
Results: Cesarean delivery rates were similar during both time periods. Heparin thromboprophylaxis was indicated in 99.6% of the cesarean delivery population before implementation and 94.5% after implementation. Prior to implementation only 5.7% received thromboprophylaxis compared to 96.1% after implementation, P<0.0001.
Conclusion: An opt-out heparin thromboprophylaxis policy improves compliance with thromboprophylaxis guidelines compared to an opt-in policy. Institutions should consider opt-out heparin thromboprophylaxis policies after cesarean deliveries to improve compliance with recommendations.
Acknowledgments
Special thanks to the residents, attending and staff at New York Presbyterian Hospital for helping with the successful implementation of this protocol.
References
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Article note: Selected paper from the New York Perinatal Society papers presented at the 36th Annual Scientific Meeting, Monday April 15, 2013.
©2014 by Walter de Gruyter Berlin Boston
Articles in the same Issue
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- Neonatal serum magnesium concentrations are determined by total maternal dose of magnesium sulfate administered for neuroprotection
- Labor induction in nulliparous women with an unfavorable cervix: double balloon catheter versus dinoprostone
- Peripartum thromboprophylaxis before and after implementation of a uniform heparin protocol
- Original articles – Fetus
- Impact of sex on perinatal mortality and morbidity in twins
- Opinion paper
- Preeclampsia is caused by continuous sympathetic center excitation due to an enlarged pregnant uterus
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- Survival and neonatal morbidity among extremely preterm born infants in relation to gestational age based on the last menstrual period or ultrasonographic examination
- Short communication
- Reference values of nuchal translucency thickness in a Brazilian population sample: experience from a single center
- Letters to the Editor
- Hepatic rupture: a rare but serious complication of HELLP syndrome
- Reply
- Reply to: hepatic rupture – a rare but serious complication of HELLP syndrome
- Congress Calendar
- Congress Calendar
Articles in the same Issue
- frontmatter
- Review articles
- Evaluation of the role of first-trimester obstetric ultrasound in the detection of major anomalies: a systematic review
- Austrian Newborn Screening Program: a perspective of five decades
- Original articles – Obstetrics
- Cervical strain determined by ultrasound elastography and its association with spontaneous preterm delivery
- Risk factors for unfavorable pregnancy outcome in women with adverse childhood experiences
- Peroxisome proliferator-activated receptor-gamma (PPARγ) is down regulated in trophoblast cells of gestational diabetes mellitus (GDM) and in trophoblast tumour cells BeWo in vitro after stimulation with PPARγ agonists
- Premature rupture of membranes at term in low risk women: how long should we wait in the “latent phase”?
- Ferrous bisglycinate 25 mg iron is as effective as ferrous sulfate 50 mg iron in the prophylaxis of iron deficiency and anemia during pregnancy in a randomized trial
- Neonatal serum magnesium concentrations are determined by total maternal dose of magnesium sulfate administered for neuroprotection
- Labor induction in nulliparous women with an unfavorable cervix: double balloon catheter versus dinoprostone
- Peripartum thromboprophylaxis before and after implementation of a uniform heparin protocol
- Original articles – Fetus
- Impact of sex on perinatal mortality and morbidity in twins
- Opinion paper
- Preeclampsia is caused by continuous sympathetic center excitation due to an enlarged pregnant uterus
- Original articles – Newborn
- Practical application of kangaroo mother care in preterm infants: clinical characteristics and safety of kangaroo mother care
- Survival and neonatal morbidity among extremely preterm born infants in relation to gestational age based on the last menstrual period or ultrasonographic examination
- Short communication
- Reference values of nuchal translucency thickness in a Brazilian population sample: experience from a single center
- Letters to the Editor
- Hepatic rupture: a rare but serious complication of HELLP syndrome
- Reply
- Reply to: hepatic rupture – a rare but serious complication of HELLP syndrome
- Congress Calendar
- Congress Calendar