Journal de la grossesse et de la santé infantile

Abstrait

Risk Stratification and Prophylaxis of Venous Thromboembolic Events in Obstetrics

Elliot M Levine, Norman A Ginsberg, Ernest Powell and Stephen Locher

Objective: To identify the risk factors for perioperative venous thromboembolism, and the possible consequences of pharmacologic thromboprophylaxis used with cesarean delivery.
Study design: An Enterprise Data Warehouse (EDW) of a multi-hospital system was queried to obtain the incidence of and risk factors for perioperative venous thromboembolism (VTE) and the use of pharmacologic thromboprophylaxis (PTP).
Results: Of 337,174 surgical patients over the course of 2010-2013, Cesarean Delivery (CD) occurred 24,608 times, with pharmacologic VTE prophylaxis (PTP) being provided 931 times (4% of the time) and 23,677 times without such prophylaxis. Hemorrhagic complications were recorded 0.08% of the time (0.3% when PTP was provided, and 0.08% without it). As this was found to be statistically significant (p=0.02), this warrants our concern, regarding the appropriateness of using PTP for all cesarean deliveries.
Conclusion: Pharmacologic thromboprophylaxis may have the risk of associated hemorrhage with its use, and it may be worthwhile to use risk stratification to decide whether or not to use it for surgical prophylaxis in particular cesarean cases.