{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T12:33:54Z","timestamp":1788698034546,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,9,21]],"date-time":"2017-09-21T00:00:00Z","timestamp":1505952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Venous thromboembolism risk assessment (<jats:styled-content style=\"fixed-case\">VTERA<\/jats:styled-content>) is recommended in all pregnant and postpartum women. Our objective was to develop, pilot and implement a user\u2010friendly electronic <jats:styled-content style=\"fixed-case\">VTERA<\/jats:styled-content> tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We developed \u201cThrombocalc\u201d, an electronic <jats:styled-content style=\"fixed-case\">VTERA<\/jats:styled-content> tool using Microsoft <jats:styled-content style=\"fixed-case\">EXCEL<\/jats:styled-content><jats:sup>\u2122<\/jats:sup>. Thrombocalc was designed as a score\u2010based tool to facilitate rapid assessment of all women after childbirth. Calculation of a total score estimated risk of venous thromboembolism in line with consensus guidelines. Recommendations for thromboprophylaxis were included in the <jats:styled-content style=\"fixed-case\">VTERA<\/jats:styled-content> output. Implementation was phased. Uptake of the <jats:styled-content style=\"fixed-case\">VTERA<\/jats:styled-content> tool was assessed prospectively by monitoring the proportion of women who gave birth in our institution and had a completed risk assessment. Factors affecting completion and accuracy of risk assessments were also assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thrombocalc was used prospectively to risk\u2010assess 8380 women between September 2014 and December 2015. Compliance with this tool increased dramatically throughout the study period; over 92% of women were risk\u2010assessed in the last quarter of data collection. Compliance was not adversely affected if delivery took place out of working hours [adjusted odds ratio (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content>) 1.03, 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 0.93\u20131.14]. Risk assessment was less likely in the case of cesarean deliveries (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 0.66, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.60\u20130.73) and stillborn infants (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 0.48, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.29\u20130.79). Misclassification of risk factors led to approximately 207 (2.5%) inaccurate thromboprophylaxis recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our electronic, score\u2010based <jats:styled-content style=\"fixed-case\">VTERA<\/jats:styled-content> tool provides a highly effective mechanism for rapid assessment of individual postpartum venous thromboembolism risk in a high\u2010throughput environment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13206","type":"journal-article","created":{"date-parts":[[2017,8,18]],"date-time":"2017-08-18T08:46:44Z","timestamp":1503046004000},"page":"1382-1390","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Thrombocalc: implementation and uptake of personalized postpartum venous thromboembolism risk assessment in a high\u2010throughput obstetric environment"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7855-6549","authenticated-orcid":false,"given":"Fergal","family":"O'Shaughnessy","sequence":"first","affiliation":[{"name":"Pharmacy Department Rotunda Hospital Dublin Ireland"},{"name":"Division of Population Health Sciences Royal College of Surgeons in Ireland Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer C.","family":"Donnelly","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Rotunda Hospital Dublin Ireland"},{"name":"Department of Obstetrics and Gynaecology Royal College of Surgeons in Ireland Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon M.","family":"Cooley","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Rotunda Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Deering","sequence":"additional","affiliation":[{"name":"Department of Midwifery Rotunda Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajita","family":"Raman","sequence":"additional","affiliation":[{"name":"Department of Midwifery Rotunda Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldine","family":"Gannon","sequence":"additional","affiliation":[{"name":"Department of Midwifery Rotunda Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Hickey","sequence":"additional","affiliation":[{"name":"Department of Midwifery Rotunda Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Holland","sequence":"additional","affiliation":[{"name":"Department of Finance Rotunda Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niamh","family":"Hayes","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Rotunda Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Bennett","sequence":"additional","affiliation":[{"name":"Division of Population Health Sciences Royal College of Surgeons in Ireland Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fionnuala","family":"N\u00ed \u00c1inle","sequence":"additional","affiliation":[{"name":"Department of Hamatology Rotunda Hospital Dublin Ireland"},{"name":"School of Medicine and SPHERE Research Group University College Dublin Conway Institute Dublin Ireland"},{"name":"Department of Hematology Mater Misericordiae University Hospital Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J.","family":"Cleary","sequence":"additional","affiliation":[{"name":"Pharmacy Department Rotunda Hospital Dublin Ireland"},{"name":"School of Pharmacy Royal College of Surgeons in Ireland Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68397-9"},{"key":"e_1_2_9_3_1","volume-title":"Saving Lives, Improving Mothers\u2019 Care \u2013 Surveillance of maternal deaths in the UK 2012\u201314 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009\u201314","author":"Knight M","year":"2016"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13172"},{"key":"e_1_2_9_5_1","volume-title":"Saving Lives, Improving Mothers\u2019 Care \u2013 Surveillance of maternal deaths in the UK 2011\u201313 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009\u201313","author":"Knight M","year":"2015"},{"key":"e_1_2_9_6_1","unstructured":"Royal College of Obstetricians and Gynaecologists.Green Top Guideline No. 37a. 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