THROMBOPROPHYLAXIS;

PREGNANT WOMEN WITH HIGH BODY MASS INDEX

Abstract

Maternal obesity (body mass index, BMI≥30kg/m²) 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. Objective: 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). Design: Retrospective study. Period: September 2005 to December 2006. Method: 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. Results:
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. Conclusions: 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.