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Peripartum thromboprophylaxis before and after implementation of a uniform heparin protocol

  • Sarah B. Anderson , Stephanie N. Lin EMAIL logo , Jonathan Reiss , Daniel Skupski and Amos Grunebaum
Published/Copyright: December 13, 2013

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.


Corresponding author: Dr. Stephanie N. Lin, NewYork-Presbyterian Weill Cornell Medical Center Department of Obstetrics and Gynecology 525 East 68th St. Box 122, New York, NY 10065, USA, Tel.: +212-746-3058, Fax: +212-746-8490, E-mail:

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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The authors stated that there are no conflicts of interest regarding the publication of this article.


Article note: Selected paper from the New York Perinatal Society papers presented at the 36th Annual Scientific Meeting, Monday April 15, 2013.


Received: 2013-7-7
Accepted: 2013-10-21
Published Online: 2013-12-13
Published in Print: 2014-3-1

©2014 by Walter de Gruyter Berlin Boston

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