Seminars in perinatology
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Seminars in perinatology · Jun 2019
ReviewLeveraging resources for obstetric venous thromboembolism prevention in a state safety collaborative.
In recent years, state obstetric quality and maternal safety initiatives have led efforts to reduce maternal risk and improve maternal safety. A priority of many of these collaboratives has been to disseminate and implement safety bundles focusing on leading causes of maternal mortality including venous thromboembolism. ⋯ This bundle was subsequently released for implementation in New York State's hospitals with support from SMI. The purpose of this review is to characterize, from the perspective of a state safety leadership collaborative, the resources that were most critical in assisting individual hospitals in (i) determining which VTE prophylaxis strategies would be adopted, and (ii) operationalizing implementation.
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Seminars in perinatology · Jun 2019
ReviewObstetric venous thromboembolism prophylaxis: What obstetricians should know about anesthesia guidelines.
In 2018 two documents were released from major anesthesia societies, the American Society for Regional Anesthesia (ASRA) and the Society for Obstetric Anesthesia and Perinatology (SOAP), to aid anesthesiologists in decision making regarding neuraxial procedures for obstetric patients receiving anticoagulation. For obstetrical providers seeking to provide appropriate inpatient thromboprophylaxis while also maximizing access to neuraxial anesthesia, awareness of these recommendations may be critically important. ⋯ Approximately one-third of women in the United States deliver by cesarean, and while many of these procedures will be scheduled, many others will be performed for an urgent indication where timing of delivery cannot be anticipated precisely. The purpose of this review is to summarize key clinical obstetric anesthesia management points related to anticoagulation for the obstetrician so that both VTE prophylaxis and access to neuraxial anesthesia can be optimized.