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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2005 February;164(1):29-33

language: Italian

Thromboprophylaxis with low molecular weight heparin in gynecologic surgery

Mancuso A., Oteri F., De Vivo A., Triolo O., Irato S.

Dipartimeno di Scienze Ginecologiche, Ostetriche e Medicina della Riproduzione, Università degli Studi di Messina, Messina


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Aim. The aim of the study is to evaluate the effectiveness of thromboprophylaxis with low molecular weight heparin in patients undergoing gynecologic surgery.
Methods. Four-hundred and ten women admitted to our Department were studied. Mean age and mean weight were of 54.6 years and 64.1 kg, respectively; 53.2% of patients were overweight. The operations were performed by abdominal route in 77.1% of cases while vaginal approach was preferred in 22.9% of patients. According to Rock and Thompson classification, 31.2% of patients had an elevated thrombotic risk, whereas all the others had a moderate risk. The thromboprophylaxis was performed by Nadroparin (0.3 ml/die) beginning 24 hours after surgery, until 7 days after discharge.
Results. Ten patients showed a symptomatology suspicious for deep vein thrombosis (DVT), however only in 4 cases clinical examinations and Doppler-color flow imaging, showed the thrombotic event. Three patients had undergone abdominal surgery owing to a benign uterine pathology, and a patient vaginal hysterectomy for prolapse. Age and weight of these patients did not differ from those of the remainders. We evidenced neither episodes of pulmonary embolism nor hemorrhagic complications of laparotomic or perineal wounds.
Conclusion. Incidence of DVT was in conformity with recent reports (0.97%). Our protocol could be suitable, after further evaluations, to decrease the incidence of intra- and postoperating bleeding with similar results in the DVT prophylaxis.

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