Jahan Ara Saeed, Muzibunissa Begam, Howaida Khair, Roos Benson.
Audit of thromboprophylaxis for caesarean section in Tawam hospital, Al Ain, UAE.
Isra Med J Jan ;4(4):259-63.

OBJECTIVES: To evaluate the thromboprophylaxis management in parturient undergoing caesarean section in our Institution to evidence based practice and to have a change in practice to International standards STUDY DESIGN: Retro respective analytic study PLACE AND DURATION OF STUDY: At Tawam Hospital, Al Ain, U.A.E. It was completed in 4 months from 1st January 2005 to 30th April 2005. METHODOLOGY: Retrospective audit of 100 consecutive women undergoing cesarean section. Collection of data from the medical records of the patient and details were collected on purpose made performa for each patient with her details and details of the indication and the surgery itself. Risk of thrombosis was assessed by the Royal College of Obstetricians and Gynaecologists [RCOG] thromboembolism risk criteria. Use of thromboprophylaxis was audited for type and duration of use and whether appropriate or not appropriate according to RCOG guideline. All the components of the performa were audited and put in SPS 14. RESULTS: Forty nine percent of the patients had some kind of thromboprophylaxis. Risk of thromboembolism was mild in (25%) moderate in (50%) and high in (25%). All mild risk patients received adequate thromboprophylaxis, while (32%) moderate and (16%) high risk had adequate thrombo-prophylaxis.and the rest had inappropriate thromboprophylaxis. Furthermore there was no uniformity in practice. CONCLUSION: The study indicated that clinicians did not follow evidence-based practice with thrombo prophylaxis when managing most patients, there was no uniformity of practice regarding the type and duration in thromboprophylaxis use. In view of this a Clinical Practice Guideline for use of thrombo prophylaxis in cesarean was issued and implemented, to be followed up with a re-audit in six months.

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