ArticleBJOG : an international journal of obstetrics and gynaecology2016
A comparison of recommendations for pharmacologic thromboembolism prophylaxis after caesarean delivery from three major guidelines.
Article in BJOG : an international journal of obstetrics and gynaecology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Thromboprophylaxis during pregnancy and the puerperium: a systematic review and economic evaluation to estimate the value of future research.Health technology assessment (Winchester, England) · 2024Pooled it
- Venous thromboembolism prophylaxis for women at risk during pregnancy and the early postnatal period.The Cochrane database of systematic reviews · 2021Pooled it
- Postpartum venous thromboembolism prophylaxis may cause more harm than benefit: a critical analysis of international guidelines through an evidence-based lens.BJOG : an international journal of obstetrics and gynaecology · 2018Pooled it
- Weight-Based Compared With Fixed-Dose Enoxaparin Prophylaxis After Cesarean Delivery: A Randomized Controlled Trial.Obstetrics and gynecology · 2022Trial
- Postpartum Pharmacologic Thromboprophylaxis Guideline Adherence and Post-Delivery Complications: A Single-Center, Retrospective Cohort Study.American journal of perinatology · 2026Article
- Recommendations from guidelines for the prevention of venous thromboembolism in pregnant women with inherited thrombophilia.Archives of gynecology and obstetrics · 2026Review
- Evaluation of the clinical performance of a risk scoring model for venous thromboembolism prophylaxis in cesarean section for a largely Chinese population.Research and practice in thrombosis and haemostasis · 2026Article
- Postoperative venous thromboembolism following cesarean delivery: prevalence, pathophysiology, diagnosis, treatment, and prevention.American journal of obstetrics and gynecology · 2026Review
- Single Center Implementation of a Postpartum Pharmacologic Thromboprophylaxis Protocol.American journal of perinatology · 2026Article
- What influences women's decisions to participate in trials for prevention of venous thromboembolism during pregnancy and the puerperium: a qualitative study.BMC pregnancy and childbirth · 2025Article
- Inpatient pharmacological thromboprophylaxis in the antepartum period: an argument for risk-based thromboprophylaxis.American journal of obstetrics & gynecology MFM · 2025Review
- A comparison of international clinical practice guidelines for postpartum venous thromboembolism prophylaxis.BMC pregnancy and childbirth · 2025Article
- Peripartum management of the patient taking anticoagulant medications.BJA education · 2025Review
- Postpartum pharmacologic thromboprophylaxis and complications in a US cohort.American journal of obstetrics and gynecology · 2024Article
- Obesity, pregnancy, and prophylaxis for venous thromboembolism.Journal of family medicine and primary care · 2023Article
- VTE prophylaxis in pregnant people with chronic physical disability: Data from a physicians survey and the need for guidance.Obstetric medicine · 2023Article
- Agreement between two scales used for assessing risk classification for thromboembolic events and the requirement of postpartum pharmacological prophylaxisRevista colombiana de obstetricia y ginecologia · 2022Article
- Risk stratification for pregnancy-associated venous thromboembolism: Potential role for global coagulation assays.Obstetric medicine · 2022Review
- Trends in postpartum venous thromboembolism and chemical prophylaxis among insured US patients.American journal of obstetrics & gynecology MFM · 2022Article
- Safety and effectiveness of fondaparinux as a postpartum thromboprophylaxis during puerperium among muslim women: A single centre prospective study.Frontiers in pharmacology · 2022Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveGuidelines for pharmacologic obstetric venous thromboembolism (VTE) prophylaxis from the American Congress of Obstetricians (ACOG), the Royal College of Obstetricians and Gynaecologists (RCOG), and the American College of Chest Physicians (Chest) vary significantly. The objective of this study was to determine the practical implications of these recommendations in terms of prophylaxis rates for a tertiary obstetric population. STUDY
designCross-sectional.
settingTertiary referral hospital. POPULATION: Patients post-operative day 1 after caesarean delivery.
methodsThis cross-sectional study evaluated rates of pharmacologic prophylaxis for women based on RCOG, ACOG, and Chest recommendations. Medical, obstetric, and demographic risk factors for thromboembolism were reviewed for individual patients. Rates of prophylaxis based on each of the guidelines with 95% confidence intervals were calculated. OUTCOME MEASURE: Recommended pharmacologic prophylaxis.
resultsAbout 293 patients were included in the analysis. Under RCOG guidelines, 85.0% of patients would receive post-caesarean pharmacologic prophylaxis [95% confidence interval (CI) 80.5-88.6%] compared with 1.0% of patients under ACOG guidelines (95% CI 0.3-3.0%) and 34.8% of patients under Chest guidelines (95% CI 29.6-40.4%). Caesarean during labour, obesity, advanced maternal age, pre-eclampsia, and multiple gestation were among the most commonrisk factors.
conclusionRecommended prophylaxis differed significantly. Under ACOG recommendations a small minority of patients would receive prophylaxis, whereas under RCOG recommendations a large majority of patients would receive low-molecular-weight heparin. Given the large differences in prophylaxis rates for post-caesarean thromboprophylaxis based on different guidelines, further research is urgently needed to compare the risks and benefits of recommendations. TWEETABLE ABSTRACT: Recommendations from major society guidelines for post-caesarean thromboprophylaxis differ greatly.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.