ORIGINAL ARTICLES   

Minerva Ginecologica 1999 May;51(5):173-6

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: Italian

Incidence of thromboembolic complications in caesarian sections and heparin prophylaxis

Corosu R., Vizzaccaro F., Moretti S.

Background and aim. Venous thromboembolism is a rare but severe complication of pregnancy and puerperium: it is the most frequent cause of death and maternal morbidity. Pregnancy leads to hemodynamic, hormonal and hematological changes which make hyoercoagulability a secondary condition. In particular, surgical birth via an abdominal route is burdened with a higher risk of thromboembolic disease compared to spontaneous birth. The aim of this study was to highlight the increased incidence of deep venous thrombosis and pulmonary embolism after caesarian section.
Methods. All the pregnant women (no=879) admitted to the institute from January 1997 to May 1998 were monitored: their clinical conditions were followed both during the last period of pregnancy and after birth in order to identify the onset of pre- and post-partum thromboembolic episodes.
Results. Among the women examined, 9 cases (1.02%) of lung embolism were observed, one of which was fatal. All 9 women had under- gone caesarian section and in all cases the thromboembolic episode occurred between the second and fourth day after birth. Prophylactic therapy was not administered in any of the above cases.
Conclusions. It is important that anti-thrombotic prophylaxis with heparin should be administered. Although this presents a number of collateral effects (hemorrhage, platelet deficiency, osteoporosis), it protects the woman from the risk of thromboembolic episodes, above all if a caesarian section is performed or if the personal and/or family medical history is positive for this pathology.