Abstract
Objectives. To compare the effectiveness of postcesarean thromboprophylaxis with two different regimens of bemiparin. Material and Methods. The study included 646 women with cesarean delivery in our hospital within a 1-year period, randomly assigned to one of two groups for prophylaxis with 3500 IU bemiparin once daily for 5 days or 3500 IU bemiparin once daily for 10 days. Results. There was one case of pulmonary embolism (first day following cesarean). An additional risk factor was present in 98.52% of the women, most frequently emergency cesarean, anemia, or obesity. The only risk factors for thromboembolic disease significantly related to pulmonary thromboembolism were placental abruption and prematurity. There were no differences in thromboembolic events among the two thromboprophylaxis regimens. Conclusions. Cesarean-related thromboembolic events were reduced in our study population due to the thromboprophylactic measures taken. Thromboprophylaxis with 3500 IU bemiparin once daily for 5 days following cesarean was sufficient to avoid thromboembolic events.
Highlights
Venous thromboembolism (VTE) remains one of the main direct causes of maternal mortality in developed countries [1,2,3,4], largely due to pulmonary thromboembolism (PE) [5,6,7] which is responsible for around 20% of maternal deaths [8]
The only risk factors for thromboembolic disease significantly related to pulmonary thromboembolism were placental abruption and prematurity
There is an increased risk of thromboembolic event, either deep venous thrombosis (DVT) or PE, during pregnancy and puerperium [5, 10], and it has been estimated that the risk of VTE is 10-fold higher [11,12,13,14,15], reaching up to 2‰[16]
Summary
Venous thromboembolism (VTE) remains one of the main direct causes of maternal mortality in developed countries [1,2,3,4], largely due to pulmonary thromboembolism (PE) [5,6,7] which is responsible for around 20% of maternal deaths [8]. Epidemiologic studies estimate the annual frequency of deep venous thrombosis (DVT) in the general population to be from 0.16‰[7] to 1‰[9], of which 2% are pregnancy related [5]. There is an increased risk of thromboembolic event, either DVT or PE, during pregnancy and puerperium [5, 10], and it has been estimated that the risk of VTE is 10-fold higher [11,12,13,14,15], reaching up to 2‰[16]. Puerperium is the period with highest VTE risk [12,13,14, 17, 18] which was reported to be up to 25-fold higher than that in nonpregnant women [12,13,14]. It has been reported that 43–60% of pregnancy-related PE episodes take place during puerperium [11, 13].
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