Thromboprophylaxis; pregnant women with high body mass index

ABSTRACT

Maternal obesity [body mass index, BMI >/= 30kg/m[2]] is a global health problem. Significant evidence is available that it is directly associated with an increased risk of venous thromboembolic events in pregnancy and puerperium. This study aims to assess our current management protocols for thromboprophylaxis and to improve them according to guidelines recommended by The Royal College of Obstetricians and Gynecologists [RCOG]. Retrospective study. September 2005 to December 2006. In this study we did a retrospective first audit cycle to evaluate the existing thromboprophylaxis management in women with high BMI [>/= 30] in our hospital. The aim was to check our compliance with RCOG recommendations and to introduce change in accordance with RCOG guidelines. In first loop of audit cycle 120 pregnant women with BMI of more than 30 were evaluated.52 [43.3%] of them had no objective assessment done during antenatal period with no instructions regarding thromboprophylaxis. 3 of these patients developed Deep vein thrombosis [DVT]. Change in practice was introduced based on findings of first loop of audit. In re-audit 120 pregnant women were reviewed with BMI of >/= 30. Ninety eight[81.6%] women received Thromboprophylaxis, 22 [18.3%] did not receive thromboprophylaxis, none of them had any thrombotic or embolic complications. Detailed objective assessment of obese pregnant women for thromboprophylaxis should be implemented in our clinical practice according to the recommendations of NICE and RCOG guidelines