Venous Thromboembolism during Pregnancy and Postpartum: Study in a Tertiary Hospital

Ryuji Kawaguchi
2016 International Journal of Pregnancy & Child Birth   unpublished
Objective: To examine whether implementing an evidence-based guideline reduces the risk of symptomatic Venous Thrombo Embolism (VTE) during pregnancy and up to 3 months postpartum. Methods: This was a hospital-based retrospective cohort study of 9,041 deliveries over a 16-year period at Nara Medical University Hospital, Japan. We compared the incidence of symptomatic VTE before (1998-2007) and after (2008-2013) the introduction of the Japanese thrombo prophylaxis guideline and analyzed the
more » ... al records of pregnant women admitted to this hospital. Result: The overall incidence of symptomatic VTE among the study subjects was 0.28% (25/9,041 deliveries), representing an incidence of Deep Venous Thrombosis (DVT) and Pulmonary Thrombo Embolism (PTE) of 0.22% and 0.05%, respectively. During the pregnancy and postpartum periods, 19 and 6 VTE cases, respectively, were observed. The risk of DVT was possibly the highest in the first trimester. All the objectively confirmed PTEs typically presented postpartum or within 26 days of delivery. Further, 96% of VTE cases had one or more large anamnestic risk factor(s). The effect was small, but the incidence of VTE (0.40% vs 0.14%) decreased by 65% during the post-implementation period. Conclusion: VTE cases may at least be partially prevented using the clinical practice guideline.
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