Deep vein thrombosis after elective cesarean section.
BACKGROUND
Pregnancy is associated with an overall 5-10 fold increased risk of venous thromboembolism (VTE). The absolute risk is highest during and shortly after delivery. Although operative delivery further increases the risk of VTE, there is no consensus on thromboprophylaxis after an elective cesarean. The aim of the present study was to investigate the frequency of symptomatic and asymptomatic deep venous thrombosis (DVT) in a low risk cesarean section population.


METHODS
Fifty-nine women undergoing elective cesarean section were screened for DVT using triplex Doppler sonography 3-5 days after delivery. Markers of activated coagulation were also followed and all women were screened for thrombophilia. Postoperative thromboprophylaxis was not given. During the same period all cases of symptomatic VTE were also recorded.


RESULTS
No DVT was detected by ultrasonography and no women developed symptomatic VTE during the six weeks follow-up period after delivery. Six women had thrombophilia. During the study period, a cesarean section was performed in 1067/5364 (20%) deliveries. Five of these women (0.47%) developed symptomatic pulmonary embolism, and all of these women had additional risk factors for VTE.


CONCLUSIONS
The risk of DVT among healthy pregnant women undergoing elective cesarean section is low, and general medical thromboprophylaxis is probably not justified.
Jacobsen
Anne Flem
AF
Department of Obstetrics and Gynecology, Ullevål University Hospital, Kirkeveien 166, N-0407 Oslo, Norway. anneflem@jacobsen@ulleval.no
Drolsum
Anders
A
Klow
Nils Einar
NE
Dahl
Gunn Fallås
GF
Qvigstad
Erik
E
Sandset
Per Morten
PM
D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D049590:Postpartum Period / Q000097:blood; D011247:Pregnancy; D011655:Pulmonary Embolism / Q000209:etiology; D012307:Risk Factors; D019851:Thrombophilia / Q000209:etiology; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control