title: [Perioperative prevention of thrombosis in cesarean section: results of a randomized prospective comparative study with 6% hydroxyethyl starch and 0.62 low dose heparin].
abstract: In 207 consecutive randomized women undergoing cesarean section, of whom 104 received 3 X 5000 IE unfractionated heparin and 103 3 X 500 ml hydroxyethylstarch 6% 0.62, the frequency of deep vein thrombosis was evaluated with a non-invasive diagnostic technique-impedance plethysmography. 5.9% of the patients in the hydroxyethylstarch group and 7.8% in the heparin-group developed deep vein thrombosis. Activation of blood coagulation at cesarean section results in an increasing of factor VIIIR:Ag, Fibrinogen and Reptilase clotting time. Hydroxyethylstarch 6% 0.62 produces minor abnormalities of coagulation test results. After 1500 ml infusions HES the following effects were noted: 1. Factor VIIIR:Ag fell by about 20%, a greater decrease than could be explained simply by hemodilution. 2. Reptilase clotting times shortened without a different increase in fibrin activation products (resulting in an increased lysability of the thrombus). 3. Plasma fibrinogen decreased by approximately 7% due to hemodilution caused by plasma volume expansion. For patients with a low risk of deep vein thrombosis (Cesarean section) HES has an excellent safety record in doses not exceeding 1500 ml/24 h.
authors.affiliation: Abt. Gynäkologie und Geburtshilfe, Stadtkrankenhauses Rüsselsheim.
authors.forename: L
authors.initials: L
authors.lastname: Heilmann
authors.forename: R
authors.initials: R
authors.lastname: Heitz
authors.forename: F U
authors.initials: FU
authors.lastname: Koch
authors.forename: C
authors.initials: C
authors.lastname: Ose
mesh_terms: D001780:Blood Coagulation Tests; D002585:Cesarean Section; D004305:Dose-Response Relationship, Drug; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage* / Q000009:adverse effects; D007231:Infant, Newborn; D010992:Plethysmography, Impedance; D011183:Postoperative Complications / Q000097:blood / Q000517:prevention & control*; D011247:Pregnancy; D011446:Prospective Studies; D013924:Thrombophlebitis / Q000097:blood / Q000517:prevention & control*
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D006493:Heparin
vernacular_title: Die perioperative Thromboseprophylaxe beim Kaiserschnitt: Ergebnisse einer randomisierten prospektiven Vergleichsuntersuchung mit 6% Hydroxyäthylstärke 0.62 und Low-dose-Heparin.