Mefkure ERASLAN ŞAHİN, İlknur ÇÖL MADENDAĞ

A critical analysis of prophylaxis to avoid venous thromboembolism after cesarean delivery

Aim: The aim of the present study was to analyze the risk factors for VTE in patients who underwent cesarean section. Pregnancy isa thrombogenic condition, and pregnant women have a five-to-six fold higher risk of VTE than non-pregnant women. The incidenceof VTE is two-to-four times higher in cesarean deliveries than in vaginal deliveries.Material and Methods: 450 pregnant women who delivered by cesarean section were analyzed. The Turkey Ministry of Health RiskPregnancy Management Guidelines was used to determine the VTE risk and its factors. After analyses of the data, the number andproportion of high-risk patients, that of medium-risk patients, and that of patients were determined.Results: After analyzing the risk factors we found that 59 (13.1%) pregnant women had a high risk, 351 (78%) had a moderate risk,and 40 (8.9%) had a low risk for VTE. In risk factor analyses, 9 women (2%) in the high-risk group had a history of VTE, 9 (2%) had ahigh risk of thrombophilia, 9(2%) had a low risk of thrombophilia and a family history of VTE, and 32(7.1%) needed low molecular–weight heparin during the antenatal period. When moderate-risk patients were classified for VTE, we found that 151 (33.6%) hadtwo or more minor risk factors, 117 (26%) required cesarean section during labor, 42 (9.3%) had a hospital stay >3 days or werereadmitted after delivery, 32 (7.1%) had a systemic disease, and 9 (2%) had a BMI>40 kg/m2.Conclusion: The results of the study suggest that the majority of pregnant women should be given VTE prophylaxis after cesareandelivery.

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