Feasibility of an easy-to-use risk score in the prevention of venous thromboembolism and placental vascular complications in pregnant women: A prospective cohort of 2736 women

Chauleur, Céline; Quenet, Sara; Varlet, Marie-Noëlle; Seffert, P.; Laporte, Silvy; Décousus, Hervé; Mismetti, Patrick

doi:10.1016/j.thromres.2007.12.020

Cited by 31 publications

(44 citation statements)

References 30 publications

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“…Among them, 1% had a previous VTE and 0·7% exhibited a congenital thrombophilia. 2685 women received the recommended treatment defined by the risk score and nine pregnancy‐related VTE occurred during the study period (Chauleur et al , 2008; Dargaud et al , 2008).…”

Section: Discussionmentioning

confidence: 99%

A risk score for the management of pregnant women with increased risk of venous thromboembolism: a multicentre prospective study

et al. 2009

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Summary Patients with thrombophilia and/or a history of venous thromboembolism (VTE) exhibit a high risk of thrombosis during pregnancy. The present multicentre study prospectively assessed a prophylaxis strategy, based on a risk score, in pregnancies with increased risk of VTE. Among 286 patients included in the study, 183 had a personal history of VTE (63·98%) and 191 patients (66·8%) had a thrombophilia marker. Eighty nine (46·6%) thrombophilic women had a personal history of VTE. Patients were assigned to one of three prophylaxis strategies according to the risk scoring system. In postpartum, all patients received low molecular weight heparin (LMWH) prophylaxis for at least 6 weeks. In antepartum, LMWH prophylaxis was prescribed to 61·8% of patients with high risk of VTE. Among them, 37·7% were treated in the third trimester only and 24·1% were treated throughout pregnancy. In this cohort, one antepartum‐related VTE (0·35%) and two postpartum‐related VTE (0·7%) occurred. No case of pulmonary embolism was observed during the study period. The rate of serious bleeding was 0·35%. There was no evidence of heparin‐induced thrombocytopenia or osteoporosis. The use of a risk score may provide a rational decision process to implement safe and effective antepartum thromboprophylaxis in pregnant women at high risk of VTE.

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Section: Discussionmentioning

confidence: 99%

A risk score for the management of pregnant women with increased risk of venous thromboembolism: a multicentre prospective study

et al. 2009

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“…Thromboprophylaxis during pregnancy usually consists of daily subcutaneous injections of low molecular weight heparin (LMWH), in combination with compression stockings [7–10]. There are several recommendations concerning how to identify women at high risk of VTE during pregnancy and the puerperium.…”

Section: Introductionmentioning

confidence: 99%

“…There are several recommendations concerning how to identify women at high risk of VTE during pregnancy and the puerperium. Some of them divide women into low-medium and high-risk groups [7, 8] and others are based on weighted risk scores [9, 10]. Risk assessment and management of obstetric thromboprophylaxis differ in different countries.…”

Section: Introductionmentioning

confidence: 99%

Obstetric Thromboprophylaxis: The Swedish Guidelines

Lindqvist

Hellgren

2011

Advances in Hematology

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Obstetric thromboprophylaxis is difficult. Since 10 years Swedish obstetricians have used a combined risk estimation model and recommendations concerning to whom, at what dose, when, and for how long thromboprophylaxis is to be administrated based on a weighted risk score. In this paper we describe the background and validation of the Swedish guidelines for obstetric thromboprophylaxis in women with moderate-high risk of VTE, that is, at similar or higher risk as the antepartum risk among women with history of thrombosis. The risk score is based on major risk factors (i.e., 5-fold increased risk of thromboembolism). We present data on the efficacy of the model, the cost-effectiveness, and the lifestyle advice that is given. We believe that the Swedish guidelines for obstetric thromboprophylaxis aid clinicians in providing women at increased risk of VTE with effective and appropriate thromboprophylaxis, thus avoiding both over- and under-treatment.

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“…Further studies addressing the management of pregnant women according to their thrombotic risk were claimed [25]. Our study add information to those stemming from other four studies [26][27][28][29] that used a scoring system for the best VTE prevention strategy in pregnant women.…”

Section: Discussionmentioning

confidence: 72%

The “Pregnancy Health-care Program” for the prevention of venous thromboembolism in pregnancy

et al. 2014

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Venous thromboembolism (VTE), i.e., deep vein thrombosis and pulmonary embolism, are among the main causes of morbidity and mortality in pregnancy with an estimated incidence of 1 per thousand women years. Recommendations on antithrombotic prophylaxis are weak. The aim of the "Pregnancy Health-care Program" (PHP) was to evaluate the individual risk of VTE in a cohort of pregnant women, and manage them with the aim of reducing the rate of VTE. The study was conducted from Jan 2008 to Dec 2010 in the hospital and obstetrical outclinics in Cremona, Italy, and included 1,787 pregnant women who received clinical observation (n = 1,197), above-knee compression stockings (n = 437) or compression stockings and low-molecular-weight heparin (LMWH) (n = 85) depending on their individual VTE risk, evaluated with a risk score (0.5-3.0) derived from the relative risk estimates of a number of risk factors. Visits were scheduled at the end of each trimester and at hospital discharge after delivery. No VTE occurred, but one superficial vein thrombosis was observed 3 days after vaginal delivery in a woman who received clinical observation (0.6 per thousand). No bleeding was observed in LMWH users. The PHP based on stratification of individual VTE risk resulted in a low incidence of VTE events.

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Feasibility of an easy-to-use risk score in the prevention of venous thromboembolism and placental vascular complications in pregnant women: A prospective cohort of 2736 women

Cited by 31 publications

References 30 publications

A risk score for the management of pregnant women with increased risk of venous thromboembolism: a multicentre prospective study

A risk score for the management of pregnant women with increased risk of venous thromboembolism: a multicentre prospective study

Obstetric Thromboprophylaxis: The Swedish Guidelines

The “Pregnancy Health-care Program” for the prevention of venous thromboembolism in pregnancy

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