Pregnant women WHO delivered in our clinic national and internationalcomparison of venous thromboembolism prophylaxis protocols in terms of applicability and efficiency

Objective: In our study, the comparison of the indications of thromboprophylaxis in different national and international guidelines in the postpartum period, evaluation of its applicability and effectiveness in our country, the cost of the drugs given for the purpose of prophylaxis in this period and the diagnosis of pulmonary embolism due to the lack of thromboprophylaxis, economy in terms of its reflection. Material and Method: The study included 652 subjects who had postpartum VTE risk scoring according to the Management Guide of Venous Thromboprophylaxis in Pregnancy Ministry of Health among 745 cases who gave birth between January 2017 and June 2018 in Gynecology and Obstetrics Clinic of Atatürk Training and Research Hospital, Ankara Yildirim Beyazit University. 93 patients were excluded from the study because postpartum thromboprophylaxis risk scoring was not performed. Scoring of 652 patients was repeated both postnatally and immediately before discharge from hospital. The demographic (age, gravida, parity) data of the patients and the factors that were present in the risk scoring were also recorded from the data in the patient registry files prepared in the hospital. linical records and hospital automation system were used as data sources. Anamnesis taken during the hospitalization and antenatal period were analyzed according to the records of the patients who applied to Obstetrics polyclinic Department of Obstetrics and Gynecology Clinic of Atatürk Training and Research Hospital, Ankara Yildirim Beyazit University. Statistical analysis Statistical Package for the Social Sciences (SPSS) ver. 21 (IBM Corp., Armonk, NY, USA). The suitability of the data for normal distribution was evaluated by Kolmogorov-Smirnov test. Data from descriptive data showing normal distribution are shown as mean ± standard deviation, number and percentage, while data not matching normal distribution are shown as median (interquartile range-IQR) (distribution range). In all statistical analyzes, p <0.05 was considered statistically significant. Conclusion: In pharmacological prophylaxis with LMWH in the case of VTE, It is observed that the Republic of Turkey Ministry of Health guideline is the highest cost, this guideline should be reviewed in the light of the current literature, and the cost of prophylactic LMWH is much higher than the cost of treatment in case of emergency caesarean delivery without any additional risk factor. According to this, it is understood that risk assessment and prophylaxis should be performed individually for VTE prophylaxis. In addition, it is recommended that the guidelines determined by RCOG should be reviewed in terms of cost effectiveness and re-evaluation of thromboprophylaxis indications. Key Words: maternal mortality, venous thromboembolism, prophylaxis, low molecular weight heparin