Quality statement 9: Risk assessment – high risk of venous thromboembolism

Quality statement 9: Risk assessment – high risk of venous thromboembolism

Quality statement

Pregnant women at high risk of venous thromboembolism at the booking appointment are referred to a specialist service.

Quality measure

Structure

a) Evidence of local arrangements to ensure that pregnant women have their risk of venous thromboembolism (VTE) assessed and recorded at the booking appointment.

b) Evidence of local arrangements to ensure that pregnant women at high risk of VTE at the booking appointment are referred to a specialist service.

Data source: a) and b) Local data collection.

Process

a) Proportion of pregnant women accessing antenatal care who have their risk of VTE recorded at the booking appointment.

Numerator – the number of women in the denominator having their risk of VTE assessed and recorded at the booking appointment.

Denominator – the number of pregnant women accessing antenatal care.

b) Proportion of pregnant women at high risk of VTE at the booking appointment who are referred to a specialist service.

Numerator – the number of women in the denominator referred to a specialist service.

Denominator – the number of pregnant women at high risk of VTE at the booking appointment.

Data source: a) and b) Local data collection.

Outcome

Incidence of VTE in pregnant women.

Data source: The Maternity Services Secondary Uses Dataset, once implemented, will collect data on VTE as a maternal critical incident (global number 17205700).

What the quality statement means for each audience

Service providers ensure that systems are in place to provide pregnant women at high risk of VTE at the booking appointment with onward referral to a specialist service.

Healthcare professionals refer pregnant women at high risk of VTE at the booking appointment to a specialist service.

Commissioners ensure they commission services which provide pregnant women at high risk of VTE at the booking appointment with onward referral to a specialist service.

Pregnant women who at the time of their booking appointment have a high chance of developing VTE (a blood clot) are referred to a specialist service.

Source guidance

Definitions

Definitions are taken from RCOG green-top guideline 37a.

High risk of VTE is defined as any of the following:

  • single previous VTE and thrombophilia (inherited or acquired) or family history

  • single previous unprovoked/oestrogen-related VTE

  • previous recurrent VTE (more than 1).

Women assessed as being at high risk should be referred to a specialist service, for example a trust-nominated thrombosis in pregnancy expert or team.