Venous Thromboembolism (VTE) is the formation of a blood clot in a deep vein, also referred to as deep vein thrombosis (DVT), and includes a very serious complication, pulmonary embolism (PE).  Pregnancy-related venous thromboembolism (VTE), is one of the leading causes of maternal morbidity and mortality, accounting for 9% of all maternal deaths in the United States and in California.

Findings from the 2002-2007 CA-PAMR data show that VTE accounted for 9% (n=29) of all maternal deaths, with an overall pregnancy related mortality risk of 0.9 maternal deaths per 100,000 live births. Nearly all of these deaths (97%) had at least some chance of preventability and more than half of them (52%) had a good-to-strong chance. 

  • Another review of maternal deaths found that pulmonary thromboembolism was the single cause of death most amenable to reduction by systematic change in practice, and thromboprophylaxis is the most readily implementable means of reducing the maternal death rate.  These strategies for preventing VTE require minimal resources and are easy to implement, therefore it has become one of the key national patient safety bundles.
  • The National Partnership for Maternal Safety recommends that all maternity patients should undergo VTE risk assessment as an outpatient at the first prenatal visit and when hospitalized, on admission and/or after delivery. Prevention of VTE is a critical element in the reduction of postoperative complications after c-sections. Early ambulation, use of non-pharmacologic interventions such as antithrombotic compression stockings and sequential compression devices are examples of tools used in prevention.

To address these issues, CMQCC together with the California Department of Public Health: Maternal, Child and Adolescent Health Division published the Improving Health Care Response to Maternal Venous Thromboembolism in 2018. 

 

Improving Health Care Response to Maternal Venous Thromboembolism Toolkit

The Improving Health Care Response to Maternal Venous Thromboembolism Toolkit was developed by the Venous Thromboembolism Task Force to encourage and facilitate systematic implementation of VTE risk assessment in California maternity units. Maternal venous thromboembolism (VTE) is a rare but life-threatening complication from blood clots for pregnant and postpartum women, and accounts for nearly 10% of all maternal deaths. All women need to be assessed throughout pregnancy and postpartum to identify those at high risk who may benefit from pharmacological thromboprophylaxis. 

The VTE Toolkit is consistent with the National Partnership for Maternal Safety (NPMS) VTE bundle and the Safe Motherhood Initiative at American Congress of Obstetrics and Gynecologists District II. The antepartum outpatient and postpartum extended duration VTE prophylaxis strategies as presented represent a consensus summary of ACOG and the American College of Chest Physicians (ACCP) guidelines. 

Download Improving Health Care Response to Maternal Venous Thromboembolism Toolkit (2018)

Beginning April 14, toolkits and related resources on our website will require a CMQCC Account login. First, locate the toolkit/resource on the website. Click on the toolkit/resource, and you will be prompted to log in or create an account. After you’ve logged in, you’ll automatically see an option to complete the download. Questions or need help? Email us at info@cmqcc.org. (Note: This is a different email than for MDC support!)