Reduction in fatal pulmonary embolism and venous thrombosis by perioperative administration of low molecular weight heparin. Gynecological ward retrospective analysis.
OBJECTIVE
To compare the frequency of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing gynecological operations without low molecular weight heparin (LMWH) prophylaxis and those receiving such prophylaxis.


METHODS
Retrospective, hospital record-based study.


METHODS
About 1785 consecutive patients without LMWH prophylaxis and 1871 ones treated with nadroparin (Fraxiparine) 7500ICU s.c. 2h before the operation and repeated daily for 5-7 days or until the patient was fully mobile. DVT was diagnosed on the basis of clinical symptoms and ultrasound examination, and PE on clinical symptoms, gasometric data, electrocardiography and chest X-ray.


RESULTS
Among the patients without prophylaxis, four cases of PE occurred (0.22%), two fatal (0.11%), 13 cases of proximal DVT (0.72%) and 41 distal DVT complications (2.3%). In LMWH, group 3 proximal DVT (0.16%) and 18 distal DVT (0.96%) developed but there were no clinically expressed pulmonary embolism. According to the Fisher's exact test, the difference between the complications in the analyzed groups is significant P<0.05.


CONCLUSIONS
The perioperative applying of LMWH to prevent DVT in the patients operated on gynecologically is effective.
Cyrkowicz
Andrzej
A
E. Szczeklik Hospital, Obstetrics and Gynecology Department, Szpitalnastreet 13, 33-100, Tarnów, Poland.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D007044:Hysterectomy; D017762:Nadroparin / Q000627:therapeutic use; D010048:Ovarian Cysts / Q000601:surgery; D010051:Ovarian Neoplasms / Q000601:surgery; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000517:prevention & control*; D012189:Retrospective Studies; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000517:prevention & control*; D014844:Vulva / Q000601:surgery
D006495:Heparin, Low-Molecular-Weight; D017762:Nadroparin