Venous thromboembolism risk and prophylaxis in hospitalized obstetric patients at a tertiary hospital in Accra, Ghana: A comparative cross-sectional study

Int J Gynaecol Obstet. 2021 Jun;153(3):514-519. doi: 10.1002/ijgo.13504. Epub 2021 Jan 13.

Abstract

Objective: To determine the prevalence of venous thromboembolism risk and thromboprophylaxis among obstetric inpatients, comparing prenatal and postnatal women.

Methods: We assessed 546 obstetric inpatients at the Korle-Bu Teaching Hospital for the prevalence study. Out of this number, 223 were recruited, comprising 111 prenatal and 112 postnatal mothers. A structured interviewer-administered questionnaire was used to obtain data on participants' venous thromboembolism risk, which was categorized into high, intermediate, and low using the Royal College of Obstetricians and Gynaecologists guidelines. Data on thromboprophylaxis were also obtained and analyzed. Values were considered statistically significant at p < 0.05.

Results: Overall venous thromboembolism risk among the study population was 82/223 (36.8%). All patients at high risk were prenatal, 59/112 (52.7%) of postnatal mothers were at intermediate risk, compared with 20/111 (18.0%) of prenatal women (p < 0.001). Prevalence of thromboprophylaxis was 5/82 (6.1%). All prenatal high-risk patients received thromboprophylaxis, whereas only 2/20 (10.0%) of women with intermediate risk received thromboprophylaxis. The incidence of venous thromboembolism was 3/546 (0.6%) in the obstetric inpatients.

Conclusion: Our study found a high prevalence of venous thromboembolism risk among obstetric inpatients at the Korle-Bu Teaching Hospital. However, thromboprophylaxis was low. Further research is needed to audit recent practice of thromboprophylaxis and perinatal outcome.

Keywords: deep vein thrombosis; hospitalized patients; pregnancy; prophylaxis; thromboembolism.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Anticoagulants / therapeutic use
  • Cross-Sectional Studies
  • Drug Utilization / statistics & numerical data
  • Female
  • Ghana
  • Hospitalization
  • Hospitals, Teaching
  • Humans
  • Pregnancy
  • Pregnancy Complications, Hematologic / epidemiology
  • Pregnancy Complications, Hematologic / prevention & control*
  • Puerperal Disorders / epidemiology
  • Puerperal Disorders / prevention & control*
  • Risk Assessment*
  • Tertiary Care Centers
  • Venous Thromboembolism / epidemiology
  • Venous Thromboembolism / prevention & control*
  • Young Adult

Substances

  • Anticoagulants