Risk factor scoring for predicting venous thromboembolism in obstetric patients.
OBJECTIVE
The aim of this study was to develop a risk factor scoring system for the prediction of venous thromboembolism in obstetric patients.


METHODS
We conducted a retrospective case-control study of all pregnant or postpartum women admitted to the Jack D. Weiler Hospital from 1987 through 1998 with a discharge diagnosis indicating thromboembolism. For each study subject the three women who were delivered immediately before that index patient were selected for the control group. Data collected included the following: history of thrombosis, age, body mass index, previous abdominal surgical procedures, presence of systemic diseases, and blood type. Each patient was assigned a score that was based on the risk factors identified.


RESULTS
We identified 21 patients who had sustained thromboembolic events during pregnancy or 6 weeks post partum. Nineteen of the thromboembolic events (90%) were diagnosed during pregnancy, and these cases were distributed throughout gestation-8 (42%) in the first trimester, 2 (10%) in the second trimester, and 9 (48%) in the third trimester. Six (28%) of these patients had pulmonary embolisms. Two cases of postpartum thromboembolic events were documented. Both were cases of pulmonary embolism. There was 1 maternal death. Patients with a score >2 were at significantly increased risk for having a thromboembolism, with an odds ratio of 4.8 (P <.05). The sensitivity, specificity, positive predictive value, and negative predictive value of this cutoff point were 21%, 95%, 57%, and 78%, respectively.


CONCLUSIONS
Obstetric patients with high risk factor scores were at increased risk for thromboembolism.
Weiss
N
N
Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY 10461-2373, USA.
Bernstein
P S
PS
D000017:ABO Blood-Group System; D015992:Body Mass Index; D016022:Case-Control Studies; D002585:Cesarean Section; D003276:Contraceptives, Oral; D005260:Female; D005865:Gestational Age; D006801:Humans; D007239:Infections; D008423:Maternal Age; D016017:Odds Ratio; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D018566:Pregnancy, High-Risk; D011644:Puerperal Disorders; D011655:Pulmonary Embolism / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis*
D000017:ABO Blood-Group System; D003276:Contraceptives, Oral