ArticleObstetrics and gynecology2021
Evaluation of a Risk-Stratified, Heparin-Based, Obstetric Thromboprophylaxis Protocol.
Article in Obstetrics and gynecology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Risk assessment models for venous thromboembolism in pregnancy and in the puerperium: a systematic review.BMJ open · 2022Pooled it
- Low Molecular Weight Heparin Thromboprophylaxis or No Treatment following Cesarean Delivery: A Pilot Randomized Controlled Trial.American journal of perinatology · 2026Trial
- Weight-Based Compared With Fixed-Dose Enoxaparin Prophylaxis After Cesarean Delivery: A Randomized Controlled Trial.Obstetrics and gynecology · 2022Trial
- Postpartum Pharmacologic Thromboprophylaxis Guideline Adherence and Post-Delivery Complications: A Single-Center, Retrospective Cohort Study.American journal of perinatology · 2026Article
- Perinatal outcomes associated with magnesium sulfate for preeclampsia without severe features.Pregnancy (Hoboken, N.J.) · 2026Article
- The association between the degree of social vulnerability and maternal anemia and other adverse perinatal outcomes.Pregnancy (Hoboken, N.J.) · 2026Article
- Evaluation of the clinical performance of a risk scoring model for venous thromboembolism prophylaxis in cesarean section for a largely Chinese population.Research and practice in thrombosis and haemostasis · 2026Article
- Postoperative venous thromboembolism following cesarean delivery: prevalence, pathophysiology, diagnosis, treatment, and prevention.American journal of obstetrics and gynecology · 2026Review
- Single Center Implementation of a Postpartum Pharmacologic Thromboprophylaxis Protocol.American journal of perinatology · 2026Article
- Association Between Comorbidities and Inpatient Postpartum Permanent Contraception Completion.Obstetrics and gynecology · 2025Article
- Inpatient pharmacological thromboprophylaxis in the antepartum period: an argument for risk-based thromboprophylaxis.American journal of obstetrics & gynecology MFM · 2025Review
- Postpartum pharmacologic thromboprophylaxis and complications in a US cohort.American journal of obstetrics and gynecology · 2024Article
- Projected impact of guidelines on incidence of venous thromboembolism after cesarean delivery in the United States.Journal of thrombosis and haemostasis : JTH · 2023Article
- Optimal predelivery hemoglobin to reduce transfusion and adverse perinatal outcomes.American journal of obstetrics & gynecology MFM · 2023Article
- Participation in obstetrical studies is associated with improved pregnancy outcomes.American journal of obstetrics & gynecology MFM · 2022Observational
- Preventing Postpartum Venous Thromboembolism in 2022: A Narrative Review.Frontiers in cardiovascular medicine · 2022Review
- Postpartum Heparin Thromboprophylaxis: More Harm Than Good.Obstetrics and gynecology · 2021Article
Corrections and comments
- Commented on by
- Commented on by
- Commented on byIn Reply.2022
- Erratum issued
Authors and funding
19 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate outcomes before and after implementation of a risk-stratified heparin-based obstetric thromboprophylaxis protocol.
methodsWe performed a retrospective cohort study of all patients who delivered at our tertiary care center from 2013 to 2018. Deliveries were categorized as preprotocol (2013-2015; no standardized heparin-based thromboprophylaxis) and postprotocol (2016-2018). Patients receiving outpatient anticoagulation for active venous thromboembolism (VTE) or high VTE risk were excluded. Coprimary effectiveness and safety outcomes were postpartum VTEs and wound hematomas, respectively, newly diagnosed after delivery and up to 6 weeks postpartum. Secondary outcomes were other wound or bleeding complications, including unplanned surgical procedures (eg, hysterectomies, wound explorations) and blood transfusions. Outcomes were compared between groups, and adjusted odds ratios (aORs) and 95% CIs were calculated using the preprotocol group as reference.
resultsOf 24,229 deliveries, 11,799 (49%) occurred preprotocol. Although patients were more likely to receive heparin-based prophylaxis postprotocol (15.6% vs 1.2%, P<.001), there was no difference in VTE frequency between groups (0.1% vs 0.1%, odds ratio 1.0, 95% CI 0.5-2.1). However, patients postprotocol experienced significantly more wound hematomas (0.7% vs 0.4%, aOR 2.34, 95% CI 1.54-3.57), unplanned surgical procedures (aOR 1.29, 95% CI 1.06-1.57), and blood transfusions (aOR 1.34, 95% CI 1.16-1.55).
conclusionRisk-stratified heparin-based thromboprophylaxis in a general obstetric population was associated with increased wound and bleeding complications without a complementary decrease in postpartum VTE. Guidelines recommending this strategy should be reconsidered.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.