Medical staff adherence to thromboprophylaxis for preventing thromboembolic disease in pregnancy and gynecological surgery

Adherencia del personal médico a la tromboprofilaxis para la prevención de enfermedad tromboembólica en la gestante y en cirugía ginecológica

Introduction: venous thromboembolism is one of the most serious and potentially fatal complications associated with pregnancy, childbirth, and gynecological surgery. Objective: to evaluate medical staff adherence to thromboprophylaxis guidelines in pregnancy and gynecological surgery settings, at Hospital Universitario San José in Popayán, during 2021. Methodology: a descriptive cross-sectional study in 2021, including pregnant, postpartum period, and gynecological surgery patients, selected by inclusion and exclusion criteria.  Material and methods: the FECOLSOG and Caprini scales were applied to classify thrombotic events risk, in-hospital adherence, and out-patient prescription in terms of time and dose. Descriptive epidemiology was used for assessing adherence, with a 95% confidence interval. Results and discussion: 807 obstetric patients and 114 gynecological surgery patients were included. Moderate risk was determined in 42.6 % of pregnancy and postpartum period cases, and 64% of gynecological surgery cases were classified as high-risk. In-hospital adherence to thromboprophylaxis in pregnancy and postpartum period was 92% (95% CI: 90-94%) in terms of time and 82% (95% CI: 90-94%) in terms of dose, with 66.7% classified as low-risk in terms of dose.  Out-patient prescription for very high-risk patients was 57.1% and 42,9% in terms of dosage and time, respectively. Outpatient adherence to thromboprophylaxis in gynecological surgery patients in terms of dose and duration was 53% (95% CI: 43% - 62%), while in terms of dose it was 32.9% for patients at high risk for thrombosis. Conclusion: the adherence to inpatient thromboprophylaxis was high in terms of both duration and dosage, but outpatient prescription was low, especially for high and very high-risk patients.