The incidence of deep vein thrombosis in women undergoing cesarean delivery

Sia, Winnie; Powrie, Raymond; Cooper, Ann; Larson, Lucia; Phipps, Maureen G.; Spencer, Patricia; Sauvé, Nadine; Rosene‐Montella, Karen

doi:10.1016/j.thromres.2008.06.004

Cited by 30 publications

(22 citation statements)

References 17 publications

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“…144 A small prospective study in which patients after cesarean section underwent screening ultrasounds at hospital discharge and 2 weeks postpartum and were followed for 3 months reported a symptomatic event rate of fi ve of 1,000 (95% CI, 0.1%-2.8%). 147 This is consistent with estimates based on hospital discharge data antedating the use of thromboprophylaxis. 138,140 Observational studies provide evidence concerning risk factors for VTE in pregnant women (Tables S10, S11) 121,146,148,[150][151][152] ; these are likely to be relevant in women undergoing cesarean section.…”

Section: Vte In Patients Using Assistedsupporting

confidence: 83%

“…121,[139][140][141][142][143][144][145][146][147][148] However, studies based on hospital records and disease coding may result in an underestimation of the true incidence of symptomatic VTE. 149 A Norwegian study of 59 low-risk women undergoing elective cesarean section who underwent screening for DVT using triplex ultrasonography (compression ultrasonography, color Doppler echocardiography, and spectral Doppler echocardiography) 2 to 5 days after delivery and followed up for 6 weeks reported that none had symptomatic or asymptomatic VTE (95% CI, 0%-6.1%).…”

Section: Vte In Patients Using Assistedmentioning

confidence: 99%

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VTE, Thrombophilia, Antithrombotic Therapy, and Pregnancy

Bates

Greer

Middeldorp

et al. 2012

Chest

1,310

591

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Summary of RecommendationsNote on Shaded Text: Throughout this guideline, shading is used within the summary of recommendations sections to indicate recommendations that are newly added or have been changed since the publication of Antithrombotic and Thrombolytic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Recommendations that remain unchanged are not shaded. Abbreviations: APLA 5 antiphospholipid antibody; aPPT 5 activated partial thromboplastin time; HIT 5 heparin-induced thrombocytopenia; INR 5 international normalized ratio; LMWH 5 low-molecular-weight heparin; NNT 5 number needed to treat; PE 5 pulmonary embolism; RR 5 risk ratio; UFH 5 unfractionated heparin

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Section: Vte In Patients Using Assistedsupporting

confidence: 83%

Section: Vte In Patients Using Assistedmentioning

confidence: 99%

VTE, Thrombophilia, Antithrombotic Therapy, and Pregnancy

Bates

Greer

Middeldorp

et al. 2012

Chest

1,310

591

View full text Add to dashboard Cite

show abstract

“…This study found that the incidence of asymptomatic DVT among women at high risk of VTE was 3.9%. Two previous studies reported that symptomatic DVT was detected in 0.04% and 0.5% of patients [6,16]. The patients in these two studies were randomly selected populations in which thromboprophylaxis was not administered.…”

Section: Discussionmentioning

confidence: 99%

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

Goto

Yoshizato

Tatsumura

et al. 2015

Taiwanese Journal of Obstetrics and Gynecology

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“…Although asymptomatic DVT has been reported in 10–40% of medical and surgical patients, symptomatic VTE occurs in fewer than 5% 7, 12, 17, 18. Yet screening studies of women after CD have found asymptomatic DVT in fewer than 1% (3/560) 34, 35, 36, 37, 38. These studies are still referenced in the ninth edition ACCP obstetric VTE guideline via a decision analysis by Blondon et al 39.…”

Section: Overestimating the Incidence Of Vtementioning

confidence: 99%

Postpartum venous thromboembolism prophylaxis may cause more harm than benefit: a critical analysis of international guidelines through an evidence‐based lens

Kotaska

2018

BJOG

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Based on prediction models and expert opinion, most obstetric venous thromboembolism guidelines recommend low‐molecular‐weight heparin for many postpartum women, including most delivering by caesarean. Scrutiny reveals major oversights: prediction models are based on studies that report asymptomatic deep vein thrombosis; risk estimates are not adjusted for time exposure; and harm caused by heparin has been overlooked. The benefits of heparin are exaggerated and its harms are under‐appreciated. Estimates of the numbers‐needed‐to‐treat and harm are universally lacking. This paper critically reviews the evidence and quantifies the benefit and harm from low‐molecular‐weight heparin in postpartum women with common risk factors.FundingThis work was unsponsored and unfunded.Tweetable abstractRandomised trials should demonstrate more benefit than harm before widespread postpartum low‐molecular‐weight heparin is recommended.

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The incidence of deep vein thrombosis in women undergoing cesarean delivery

Cited by 30 publications

References 17 publications

VTE, Thrombophilia, Antithrombotic Therapy, and Pregnancy

VTE, Thrombophilia, Antithrombotic Therapy, and Pregnancy

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

Postpartum venous thromboembolism prophylaxis may cause more harm than benefit: a critical analysis of international guidelines through an evidence‐based lens

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