A randomised trial to compare the effect of pre- or postoperative nandroparin on blood loss during elective caesarean section

Cornette, J.; Jacquemyn, Yves; Vercauteren, M.; Buytaert, Ph.

doi:10.1007/bf02637189

Cited by 4 publications

(4 citation statements)

References 12 publications

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“…Generation of the randomisation sequence was adequate in four trials (Casele 2006; Gates 2004a; Gates 2004b; Pettila 1999) and unclear in 10 trials (Burrows 2001; Cornette 2002; Gibson 1998;Heilmann 2007; Heilmann 1991; Hill 1988; Howell 1983; Krauss 1994; Segal 1975; Welti 1981). Methods of sequence generation reported included: random numbers table in one study (Casele 2006) a central telephone randomisation service in two studies (Gates 2004a; Gates 2004b), and a computer generated list (Pettila 1999).…”

Section: Resultsmentioning

confidence: 99%

“…More information on these studies is provided in the Characteristics of included studies tables, but these studies have not contributed data to the analyses in the review. One further study, otherwise eligible for inclusion (Cornette 2002) examined the timing of LMW heparin with the first dose administered during versus after caesarean; again we have included details of this study in the Characteristics of included studies tables and have provided a brief summary of results, but we have not included it in any treatment comparisons in the review. In the results section below we will describe findings for those 13 included studies which contributed data to the review.…”

Section: Resultsmentioning

confidence: 99%

“…98 women completed the study (18% attrition) but of the 22 women who were lost to follow up some data were available for some outcomes. It appeared that all women were accounted for in some of the analysis but not for the main study outcomeThere were some missing data for main outcomes (bone mass) and denominators were not always clear Cornette 2002…”

Section: Characteristics Of Included Studies [Ordered By Study Id]mentioning

confidence: 99%

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Prophylaxis for venous thromboembolic disease in pregnancy and the early postnatal period

Tooher

Gates

Dowswell

et al. 2010

Cochrane Database of Systematic Reviews

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Background Venous thromboembolic disease (TED), although rare, is a major cause of maternal mortality and morbidity, hence methods of prophylaxis are often used for women at risk. This may include women delivered by caesarean section, those with a personal or family history of TED and women with inherited or acquired thrombophilias (conditions that predispose people to thrombosis). Many methods of prophylaxis carry a risk of side effects, and as the risk of TED is low, it is possible that the benefits of thromboprophylaxis may be outweighed by harm. Current guidelines for clinical practice are based on expert opinion only, rather than high quality evidence from randomised trials. Objectives To determine the effects of thromboprophylaxis in women who are pregnant or have recently delivered and are at increased risk of TED on the incidence of venous TED and side effects of treatment. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (May 2009). Selection criteria Randomised trials comparing one method of thromboprophylaxis with placebo or no treatment, and randomised trials comparing two (or more) methods of thromboprophylaxis. Data collection and analysis Two review authors extracted data independently and resolved any discrepancies by discussion. Main results Sixteen trials met the inclusion criteria but only 13 trials, involving 1774 women, examining a range of methods of thromboprophylaxis, contributed data for the outcomes of interest. Four of them compared methods of antenatal prophylaxis: low molecular weight heparin (LMWH) versus unfractionated heparin (UFH) (two studies), and heparin versus no treatment (two studies). Eight studies assessed postnatal prophylaxis after caesarean section; one compared hydroxyethyl starch with unfractionated heparin; four compared heparin with placebo; and the other three compared UFH with LMWH. One study examined prophylaxis in the postnatal period. The small number of statistically significant findings in this review are largely derived from trials which are not of high methodological quality. It was not possible to assess the effects of any of these interventions on most outcomes, and especially on rare outcomes such as death, TED and osteoporosis, because of small sample sizes and the small number of trials making the same comparisons.There was some evidence of side effects associated with thromboprophylaxis. Authors’ conclusions There is insufficient evidence on which to base recommendations for thromboprophylaxis during pregnancy and the early postnatal period. Large scale randomised trials of currently-used interventions should be conducted.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of Included Studies [Ordered By Study Id]mentioning

confidence: 99%

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Prophylaxis for venous thromboembolic disease in pregnancy and the early postnatal period

Tooher

Gates

Dowswell

et al. 2010

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

show abstract

“…Regarding the timing of administration of LMWHs, Van Wijk et al (15) studied the relation between time interval between the administration of prophylactic LMWH and delivery (by cesarean section) and found that administration of LMWH within two hours of surgery resulted in a significantly larger percentage of wound hematomas (12 vs 3%). Another study by Cornette et al (16) studied the effects of pre‐ or postoperative nadroparin administration on blood loss during cesarean section. They found no differences in blood loss or postoperative hemoglobin levels.…”

Section: Discussionmentioning

confidence: 99%