Prophylaxis of thromboembolic disease in obstetrics after the French guidelines publication

Objectives. - This work is a study of the prophylaxis of maternal venous thromboembolism (VTE) after the publication of the French guidelines and a comparison between the practice and the guidelines. Population and methods. - Inquiry into the practice of 193 anaesthetists from maternities of the Rhone-Alps area has been made. Results. - Of the 48.2% anaesthetists who answered, 92.5% of them estimate that the caesarean is a risk factor of VTE; 87% prescribe an antithrombotic treatment and 6.5% treat differently the prophylactic caesareans and the urgent ones. The classification of the risk factors is identical to the guidelines for the age, the hypertension and the prophylactic caesarean (p < 0.0001). For all the other factors, the risk is overestimated, leading to an over-treatment. Eighty percent of the anaesthetists read the guidelines and 84% give them a positive value. There is a better adequacy between the guidelines and the professionals from university hospitals as compared to the non university hospitals ones (p = 0.0027). Discussion and conclusions. - Patients are managed approximately and very differently from one consultant to another. A facility of use of the guidelines will undoubtedly make it possible to obtain a more coherent attitude. (C) 2007 Elsevier Masson SAS. Tous droits reserves.