Following the positive results of our in-hospital, prospective observational study, the geko™ device is now in routine use on our maternity ward.

Working in partnership with Firstkind, we embraced the opportunity to examine the level of unmet need in our maternity patients when low molecular weight heparin (LMWH) and/or pneumatic mechanical compression (IPC) could not be used.

Pulmonary embolism (PE) is the leading cause of maternal death in the developed world¹. Patients are 5 times more likely to develop deep vein thrombosis (DVT) during pregnancy². The UK incidence of VTE in pregnancy and the puerperium is 1–2 episodes per 1,000 patients³ and accounts for 10% of all maternal deaths in the United States⁴.

NICE and the Royal College of Obstetricians and Gynaecologists (RCOG) recommends the use of low molecular weight heparin (LMWH) and/or mechanical compression in high-risk patients during childbirth. In some circumstances however, these options of prophylaxis can be contraindicated, for example:

• Post-partum haemorrhage (PPH)
• Low platelets
• Severe pre-eclampsia
• Intrapartum

Our study⁵ focused on 90 patients over a period of 17 months and showed that all 90 patients required the geko™ device during some stage of labour, representing a 2% need overall.

More than half were prescribed the device as the only method of blood clot prevention. Of these:

• 54% (49/90) postnatal patients needed the geko™ device as their only method of thrombo-prophylaxis
• 94% (46/49), of the 54%, had postpartum haemorrhage (PPH)
• 6% (3/49) had low platelets for which Daletparin was contra-indicated
• 16% (15/90) with severe preeclampsia benefitted from the geko™ device antenatally during their admission as they were at risk of needing urgent delivery
• 14% (13/90) had severe oedema or high BMI resulting in TED stockings being impractical to use.
• 8% (7/90) were deemed high risk therefore the geko™ device was used to aid their mobility.
• 2% (2/90) of patients who had antenatal Daletparin used the geko™ device during labour