Safety and efficacy of thromboprophylaxis using enoxaparin sodium after cesarean section: A multi-center study in Japan

Goto, Maki; Yoshizato, Toshiyuki; Tatsumura, M.; Takashima, Takeshi; Ogawa, Masanobu; Nakahara, Hiromasa; Satoh, Shoji; Sanui, Ayako; Eguchi, Fuyuki; Miyamoto, Shingo

doi:10.1016/j.tjog.2014.09.008

Cited by 15 publications

(12 citation statements)

References 23 publications

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“…Elektif sezaryen sonrası VTE insidansı 0.63/1000, acil sezaryen sonrası VTE insidansı ise 0.84/1000 olarak bildirilmiştir (17). Postpartum trombofilaksinin etkinliğini gösteren çalışmalar mevcuttur (18).…”

Section: Discussionunclassified

Sezaryen Sonrası Tromboflaksisinin Uygulanan Olguların Değerlendirilmesi

Bıyık¹

2020

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Amaç: Karacabey Devlet Hastanesi'nde sezaryen sonrası enoksaparin ile uygulanan tromboprofilaksinin endikasyonları ve etkinliği değerlendirildi. Hastalar ve yöntem: Karacabey Devlet Hastanesinde 1 Ocak 2018-31 Aralık 2018 tarihleri arasında toplam 611 doğum gerçekleştirildi. 328 (%54) gebe sezaryen ile doğurtuldu. Sezaryen ile doğurtulan gebelerin 22 (%7)'sine enoksaparin ile 10 gün postpartum tromboflaksi uygulandı. Hastalar postoperatif 11.günde kontrole çağrıldı. Kontrollerinde DVT, pulmoner emboli, ilaç alerjisi, kanama, enjeksiyon yerinde reaksiyon açısından sorgulandı. Bulgular: Olguların yaş ortalaması 29,68 ± 6,02 yıl olarak hesaplandı. Sezaryen endikasyonları arasında en sık eski sezaryen 9 (%40,9) bulunmaktaydı. Trombofilaksi endikasyonları arasında en sık obezite 12 (%54,5) bulunmaktaydı. 13 (%59,1) lohusaya enoksaparin 60 mg/gün, 9 (%40,9)'una ise enoksaparin 40 mg/gün dozunda trombofilaksi verildi. Olguların hiçbirinde DVT, pulmoner emboli veya enoksaparine bağlı komplikasyon görülmedi. Sonuç: Bu çalışmada tromboemboli açısından yüksek-orta riske sahip gebelere düşük molekül ağırlıklı heparin ile trombofilaksi verilmesi nin etkin ve güvenli olduğu bulundu.

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Section: Discussionunclassified

Sezaryen Sonrası Tromboflaksisinin Uygulanan Olguların Değerlendirilmesi

Bıyık¹

2020

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“…Presently, the rate of CS, a significant risk factor for venous thromboembolism, has been steadily increasing over the past decades[1]. After CS, the incidences of PE and DVT are 0.06% and 0.04%, respectively, among the samples of the general population in Japan, which represent 22- and five-times higher risks than those after vaginal delivery[20,21]. Based on the serious risk of thrombosis, post-caesarean thromboprophylaxis has been advocated even though the evidence is still limited.…”

Section: Discussionmentioning

confidence: 99%

The efficacy and safety of pharmacologic thromboprophylaxis following caesarean section: A systematic review and meta-analysis

et al. 2018

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ObjectiveOur purpose is to evaluate the efficacy and safety of pharmacologic thromboprophylaxis following caesarean section (CS).MethodsWe searched PubMed, Embase, and the Cochrane Library. Then the systematic review was performed by analysing studies that met the eligibility criteria.ResultsSeven studies with 1243 participants were included, including 6 RCTs and 1 prospective cohort. Results from the meta-analysis showed that low molecular weight heparin (LMWH) was associated with no obvious decrease in the risk of thrombus compared with UHF and negative control. However, LMWH was observed to be associated with a definite increase in the risk of bleeding or haematomas in comparison to negative control (RR: 8.47, CI: 1.52–47.11).ConclusionAccording to current evidences, the efficacy of pharmacologic thromboprophylaxis which increases the risk of bleeding or hematomas remains controversial.

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“…Because deep venous thrombosis may readily develop during the perioperative period of laparoscopic surgery[54], optimal thromboprophylaxis in surgical patients must consider the risks of deep venous thrombosis and bleeding complications[55]. According to the risk assessment performed in each case[55], prophylaxis for deep venous thrombosis is routinely performed not with unfractionated heparin but with low-molecular-weight heparin, such as enoxaparin sodium (Clexane; Kaken Pharmaceutical, Tokyo, Japan)[56]. …”

Section: Discussionmentioning

confidence: 99%

Protocol for laparoscopic cholecystectomy: Is it rocket science?

Hori¹,

Oike²,

Furuyama³

et al. 2016

WJG

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Laparoscopic cholecystectomy (LC) does not require advanced techniques, and its performance has therefore rapidly spread worldwide. However, the rate of biliary injuries has not decreased. The concept of the critical view of safety (CVS) was first documented two decades ago. Unexpected injuries are principally due to misidentification of human factors. The surgeon’s assumption is a major cause of misidentification, and a high level of experience alone is not sufficient for successful LC. We herein describe tips and pitfalls of LC in detail and discuss various technical considerations. Finally, based on a review of important papers and our own experience, we summarize the following mandatory protocol for safe LC: (1) consideration that a high level of experience alone is not enough; (2) recognition of the plateau involving the common hepatic duct and hepatic hilum; (3) blunt dissection until CVS exposure; (4) Calot’s triangle clearance in the overhead view; (5) Calot’s triangle clearance in the view from underneath; (6) dissection of the posterior right side of Calot’s triangle; (7) removal of the gallbladder body; and (8) positive CVS exposure. We believe that adherence to this protocol will ensure successful and beneficial LC worldwide, even in patients with inflammatory changes and rare anatomies.

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Safety and efficacy of thromboprophylaxis using enoxaparin sodium after cesarean section: A multi-center study in Japan

Abstract: The current study demonstrates the safety and efficacy of enoxaparin for thromboprophylaxis after C/S. Further studies are required to determine the best method of preventing asymptomatic DVT.

Cited by 15 publications

References 23 publications

Sezaryen Sonrası Tromboflaksisinin Uygulanan Olguların Değerlendirilmesi

Sezaryen Sonrası Tromboflaksisinin Uygulanan Olguların Değerlendirilmesi

The efficacy and safety of pharmacologic thromboprophylaxis following caesarean section: A systematic review and meta-analysis

Protocol for laparoscopic cholecystectomy: Is it rocket science?

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