Inclusion Criteria:

- All patients undergoing open laparotomy (non-laparoscopic) gynecologic surgery.

- Patients must be competent to self-administer injections, or must have caregivers or
nurses who can perform injections

- Patients must have signed an approved informed consent

Exclusion Criteria:

- Patients with medical history which requires chronic anticoagulation (i.e. previous
DVT, pulmonary embolism, atrial fibrillation, heart valve replacement)

- Patients with contraindications to anticoagulation (generalized bleeding disorders,
peptic ulcer disease, hemorrhagic stroke, etc)

- Contraindications to placement of ICDs (history of lower extremity venous stasis
ulcers)

- Patients receiving low molecular weight heparin or unfractionated heparin for
prophylaxis post-operatively

- Patients who are unable to receive injections as an outpatient and/or unable to
undergo a doppler ultrasound of the lower extremities

- Renal insufficiency (creatinine clearance < 30 mL/min)

- Patients who have a body weight < 50 kg

- Hypersensitivity to low molecular weight heparin

- Patients who are pregnant or have a positive pregnancy test.

- Patients receiving continuous (indwelling) epidural.