This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. Apply the CMQCC First Prenatal Visit Risk Assessment to your practice
2. Discuss the ACOG definitions for anticoagulation regimens for the prevention and treatment of maternal VTE
Estimated time to complete activity: 0.25 hours
Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.
Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from April 8 2018 through 07/15/2022, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.
Designated for 0.1 contact hours of pharmacotherapy credit for Advance Practice Registered Nurses.
The CMQCC has released a toolkit to help providers assess risk and manage maternal venous thromboembolism (VTE). The toolkit provides valuable information on risk assessment, suggested prophylaxis and treatment regimens that include prophylactic and therapeutic dosage schedules for low molecular weight heparin (LMWH) and unfractionated heparin (UFH).
The executive summary states
The Task Force Members have worked to maintain fundamental consistency with the National Partnership for Maternal Safety (NPMS) VTE bundle and the Safe Motherhood Initiative/ ACOG District II to avoid creating disparate expert consensus and guidance. The antepartum outpatient and postpartum extended duration VTE prophylaxis strategies as presented here are not controversial and represent a consensus summary of ACOG and the American College of Chest Physicians (ACCP) guidelines.
PROPHYLACTIC DOSE (LMWH or UFH)
Note: ACOG includes prophylactic, intermediate dose or adjusted dose LMWH/UFH for history of single unprovoked DVT (including DVT in prior pregnancy or related to hormonal contraceptive use) – see ACOG dosing below
THERAPEUTIC DOSE (LMWH or UFH); MFM and/or HEMATOLOGY SPECIALIST CO-MANAGEMENT RECOMMENDED
Important Note: CMQCC, referring to their VTE toolkit risk assessment algorithms states “In this document, unless otherwise specified, prophylactic LMWH dosing is defined as fixed dose enoxaparin 40 mg subcutaneously every 24 hours and therapeutic LMWH as enoxaparin 1 mg/kg subcutaneously every 12 hours. Low-dose UFH is defined as UFH 5000 units subcutaneously every 12 hours.” (Find ACOG definitions in ‘Key Points’ below)
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OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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