Abstract
Venous Thromboembolism (VTE) is associated with high morbidity and mortality rates after cesarean sections. VTE is likely four-time greater following cesarean section than normal vaginal delivery. Despite a large number of published studies and the availability of well-evidenced guideline recommendations for VTE prevention, it is evident that these guidelines are poorly implemented with suboptimal use of a prophylactic thrombotic agent. The objective of our study was to assess the knowledge and practice of gynecologists and obstetricians about guidelines of VTE prophylaxis after cesarean section. An observational study included 57 gynecologists and obstetricians from all hospitals in Al-Najaf province. The study used a validated questionnaire consisting of 40 items where the correct response scored 1, giving an overall total score of 40. The total overall knowledge and practice score was calculated for participants, and the knowledge and practice levels were evaluated. Only 57 participants out of 67 completed the study giving a response rate of 85%. The mean overall score of practice and adherence was 0.51±0.09. This study showed inadequate practice towards VTE and poor adherence to prophylaxis guidelines because of many barriers, mainly the cost, poor patient adherence, and inconvenience to use guidelines in our patients.
Highlights
In daily practice, gynecologists and obstetricians face many venous thromboembolism (VTE) cases; prophylaxis for this disorder is important before and after surgery [1]
There are many standard guidelines concerning best practices for treating, diagnosing, preventing, and managing VTE like those published by the Royal College Of Gynecologists and Obstetricians RCOG [2], American College of Chest Physicians (ACCP) [3], American College of Obstetricians and Gynecologists (ACOG)[4], and Agency for Health Care Research and Quality (AHRQ)[5]
36 physicians (63.2%) claimed they followed a specific guideline of thromboprophylaxis, and 21 (36.8%) did not, but they depend on their clinical practice and judgment (Table 1)
Summary
Gynecologists and obstetricians face many venous thromboembolism (VTE) cases; prophylaxis for this disorder is important before and after surgery [1]. Ward Thrombosis Day has an essentially educational purpose providing the family and the patient with enough information to advocate for VTE prevention, in high-risk cases in the hospital [5]. VTE is represented as the most important cause of morbidity and mortality in pregnant women after cesarean section [7]. The most common risk factor for VTE is a cesarean section. This study aims to assess the knowledge and practice of VTE prophylaxis after cesarean section in Najaf hospitals
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