Thromboembolism Prophylaxis Underused After C-Section
Despite large increases in adoption, fewer than half of those undergoing cesarean receive prophylaxis
TUESDAY, Nov. 12 (HealthDay News) -- Thromboembolism prophylaxis is underused among women who undergo cesarean delivery in the United States, according to a study published online Nov. 6 in Obstetrics & Gynecology.
Alexander M. Friedman, M.D., from Columbia University in New York City, and colleagues analyzed the use of venous thromboembolism prophylaxis after cesarean delivery in the United States between 2003 and 2010 using data from a commercial hospitalization database. Prophylaxis was characterized as pharmacologic, mechanical, combined, or none.
The researchers found that, of the 1,263,205 women who underwent cesarean delivery, 75.7 percent received no thromboembolism prophylaxis, while 22.1, 1.3, and 1.0 percent, respectively, received mechanical prophylaxis alone, pharmacologic prophylaxis, and combination prophylaxis. From 2003 to 2010, there was an increase in the rate of prophylaxis from 8.4 to 41.6 percent. There was significant variation in prophylaxis rates by geographic region. Only modest increases in prophylaxis were associated with medical risk factors.
"Although our findings demonstrated increased adoption of postcesarean venous thromboembolism prophylaxis, fewer than half of patients received recommended care as of 2010, and significant variation was present," the authors conclude. "Thromboembolism prophylaxis is underused and represents a major opportunity to reduce maternal morbidity and mortality."