Factors limiting women's adherence to venous thromboembolism prophylaxis after cesarean section in the Gaza Strip: A cross-sectional study

Phlebology. 2024 Feb;39(1):29-36. doi: 10.1177/02683555231207712. Epub 2023 Oct 17.

Abstract

Objectives: We evaluate the rates and limitations of women's adherence to low molecular weight heparin (LMWH) after cesarean section (CS) in the Gaza Strip.

Methods: Women who underwent CS were recruited consecutively. Communication offered to women, adherence to Venous thromboembolism (VTE), and its limiting factors were surveyed.

Results: 281 women participated (mean age 27.9 years). 51.95% fully adhered to VTE prophylaxis. Causes of suboptimal adherence were: 51.1% did not feel VTE prophylaxis was important, 37.8% due to high drug cost, and 11.1% didn't receive a prescription for LMWH at discharge. Poor communication was evident as 48.8% of the sample did not receive any instructions about the technical method of LMWH injection, 45.6% did not receive any information about the clinical significance of heparin, and 74.7% were unaware of LMWH side effects.

Conclusion: There is inadequate adherence to VTE prophylaxis after CS among Gaza women, mostly due to a lack of appropriate communication but also due to drug costs.

Keywords: Preventive health care; cesarean birth; health equity; pregnancy complications; quantitative research.

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use
  • Cesarean Section / adverse effects
  • Cross-Sectional Studies
  • Female
  • Heparin, Low-Molecular-Weight* / therapeutic use
  • Humans
  • Pregnancy
  • Venous Thromboembolism* / etiology
  • Venous Thromboembolism* / prevention & control

Substances

  • Heparin, Low-Molecular-Weight
  • Anticoagulants