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National Partnership for Maternal Safety

Consensus Bundle on Venous Thromboembolism

D'Alton, Mary E. MD; Friedman, Alexander M. MD; Smiley, Richard M. MD, PhD; Montgomery, Douglas M. MD; Paidas, Michael J. MD; D'Oria, Robyn MA, RNC, APN; Frost, Jennifer L. MD, MPH; Hameed, Afshan B. MD; Karsnitz, Deborah CNM, DNP; Levy, Barbara S. MD; Clark, Steven L. MD

doi: 10.1097/AOG.0000000000001579
Contents: Consensus Statement

Obstetric venous thromboembolism is a leading cause of severe maternal morbidity and mortality. Maternal death from thromboembolism is amenable to prevention, and thromboprophylaxis is the most readily implementable means of systematically reducing the maternal death rate. Observational data support the benefit of risk-factor-based prophylaxis in reducing obstetric thromboembolism. This bundle, developed by a multidisciplinary working group and published by the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care, supports routine thromboembolism risk assessment for obstetric patients, with appropriate use of pharmacologic and mechanical thromboprophylaxis. Safety bundles outline critical clinical practices that should be implemented in every maternity unit. The safety bundle is organized into four domains: Readiness, Recognition, Response, and Reporting and Systems Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged.

Routine risk-based assessment and appropriate prophylaxis may reduce the risk of obstetric thromboembolism.

Columbia University College of Physicians and Surgeons, New York, New York; the Society for Obstetric Anesthesia and Perinatology, Milwaukee, Wisconsin; Kaiser Permanente Riverside Medical Center, Riverside, California; Yale Women and Children's Center for Blood Disorders and Preeclampsia Advancement, New Haven, Connecticut; the Association of Women's Health, Obstetric and Neonatal Nurses, Washington, DC; the American Academy of Family Physicians, Leawood, Kansas; California Maternal Quality Care Collaborative, Stanford, California; the American College of Nurse-Midwives, Silver Spring, Maryland; the American College of Obstetricians and Gynecologists, Washington, DC; and Baylor College of Medicine/Texas Children's Hospital, Houston, Texas.

Corresponding author: Alexander M. Friedman, MD, Division of Maternal-Fetal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, 622 West 168th Street, PH 16-66, New York, NY 10032; e-mail:

This article is being published concurrently in the September/October 2016 issue (Vol. 45, No. 5) of Journal of Obstetric, Gynecologic, & Neonatal Nursing, the September/October 2016 issue (Vol. 61, No. 5) of Journal of Midwifery & Women's Health, and the October 2016 issue (Vol. 123, No. 4) of Anesthesia & Analgesia.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.