Our Summary
This study looked at how well doctors followed guidelines to prevent blood clots in women who had C-sections. The risk of blood clots is four times higher after a C-section than after a vaginal birth. The researchers also wanted to see if a written reminder could improve how well doctors stuck to these rules.
They analyzed the medical records of 233 women aged 19 to 32 who had C-sections between 2016 and 2017. They found that only 29% of the patients received the recommended care to prevent blood clots. In the group with the lowest risk, 86% got the right care. In the medium risk group, it was 26% and in the high-risk group, it was 100%.
A written reminder was included in the medical records of 18% of the patients. When the written reminder was present, 61% of the women received the right care, compared to 22% when there was no written reminder.
For women where the C-section was the only risk factor, only 8% got the recommended care, compared to 30% of those who had at least one other risk factor.
The study concluded that doctors don’t follow the guidelines to prevent blood clots as well as they should in women who’ve had C-sections. However, a written reminder seems to improve how well they follow these guidelines.
FAQs
- What was the purpose of the study on C-sections and blood clots?
- Did the presence of a written reminder in the medical records improve the rate of preventative care for blood clots post C-section?
- What was the compliance rate of doctors following blood clot prevention guidelines for women who had C-sections, as found in the study?
Doctor’s Tip
A helpful tip a doctor might tell a patient about cesarean section is to ask about and ensure they receive the recommended care to prevent blood clots following the procedure. This may include medications, compression stockings, and early mobilization. Additionally, patients should discuss any other risk factors they may have for blood clots with their healthcare provider to ensure appropriate preventative measures are taken.
Suitable For
Patients who are typically recommended cesarean section include:
- Women with certain medical conditions that may make vaginal delivery risky, such as placenta previa, active genital herpes infection, or certain heart conditions
- Women carrying multiple babies (twins, triplets, etc.)
- Women with a previous C-section delivery
- Women who have had a previous complicated vaginal delivery
- Fetal distress or other complications during labor that may make vaginal delivery unsafe
- Women with certain pregnancy complications, such as preeclampsia or gestational diabetes
- Women with a breech presentation (baby is positioned feet or buttocks first)
Timeline
Before a cesarean section:
- Patient is informed by their healthcare provider that a C-section may be necessary due to various reasons such as baby in distress, breech position, or maternal health concerns.
- Patient undergoes pre-operative testing and consultations to ensure they are fit for surgery.
- Patient receives anesthesia before the procedure begins.
- Surgical team performs the cesarean section, which involves making an incision in the abdomen and uterus to deliver the baby.
- Baby is born and taken to the neonatal team for assessment.
- Patient is monitored closely for any complications during the surgery and post-operatively.
After a cesarean section:
- Patient is moved to a recovery room where they are monitored for vital signs and pain management.
- Patient is encouraged to start moving around as soon as possible to prevent blood clots and aid in recovery.
- Patient is given instructions on how to care for the incision site and manage pain at home.
- Patient may receive medication to prevent blood clots, as they are at a higher risk post-surgery.
- Patient is advised on post-operative care, including when to follow up with their healthcare provider and how to care for their newborn.
- Patient may experience discomfort, fatigue, and difficulty with mobility in the days following the surgery.
- Patient is encouraged to rest, stay hydrated, and seek help if they experience any complications such as fever, excessive bleeding, or signs of infection.
What to Ask Your Doctor
- What are the specific guidelines for preventing blood clots after a C-section?
- What are the risk factors that may increase my likelihood of developing blood clots after a C-section?
- Will I be given any medications or treatments to reduce the risk of blood clots after my C-section?
- How often will I need to move around or do exercises to prevent blood clots?
- What signs and symptoms should I watch out for that may indicate a blood clot after my C-section?
- Are there any lifestyle changes or precautions I should take to reduce my risk of blood clots after a C-section?
- Will I need any follow-up appointments or tests to monitor for blood clots after my C-section?
- How common are blood clots after a C-section, and what is the typical course of treatment if one develops?
- Are there any additional steps I can take to further reduce my risk of blood clots after a C-section?
- How effective is a written reminder in ensuring that doctors follow the guidelines for preventing blood clots after a C-section, and will I receive one as part of my care?
Reference
Authors: Grille S, Maggiari L, Morales I, Ojeda J, Pérez B, Pérez I, Ribero V, Guillermo C. Journal: Rev Med Chil. 2021 Jun;149(6):881-887. doi: 10.4067/s0034-98872021000600881. PMID: 34751347