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(Journal Article) |
Gynecologie, obstetrique & fertilite 36 (1): 23-34 (2008)
[Prophylaxis of thromboembolic disease in obstetrics after the French guidelines publication].
C Chauleur
,
C Vieira
,
P Seffert
ABSTRACT
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.Inquiry into the practice of 193 anaesthetists from maternities of the Rhône-Alps area has been made.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).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.