title: No increase in hemorrhagic complications with thromboprophylaxis using low-molecular-weight heparin soon after cesarean section.
abstract: OBJECTIVE
  Data from Japanese women have been lacking regarding hemorrhagic complications due to low-molecular-weight heparin (LMWH) as thromboprophylaxis. Thus, targeting Japanese women, we made an effort to determine: (i) whether the administration of LMWH soon after cesarean section increases the risk of hemorrhagic complications compared to that of unfractionated heparin; and (ii) how it elongates the activated partial thromboplastin time.
  
  
  METHODS
  We administered unfractionated heparin in the first half of the study period, and LMWH in the latter half. We examined: (i) the incidence rate of hemorrhagic complications; and (ii) preoperative and postoperative activated partial thromboplastin time, and we compared these in cases using unfractionated heparin and LMWH.
  
  
  RESULTS
  No clinically discernable thromboembolism occurred in either group. Hemorrhagic complications occurred in two of 140 women in the unfractionated heparin group and one of 131 women in the LMWH group. LMWH prolonged the activated partial thromboplastin time from 29.8±2.6 to 34.8±4.0 s. This prolongation was significantly shorter than that with unfractionated heparin (from 30.2±2.6 to 36.5±6.2 s).
  
  
  CONCLUSIONS
  Compared with thromboprophylaxis with unfractionated heparin, thromboprophylaxis with early administration of LMWH after cesarean section did not increase the incidence of hemorrhagic complications and caused less prolongation of the activated partial thromboplastin time in Japanese women.
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, Japan. twatnabe@jichi.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Shigeki
authors.initials: S
authors.lastname: Matsubara
authors.forename: Rie
authors.initials: R
authors.lastname: Usui
authors.forename: Akio
authors.initials: A
authors.lastname: Izumi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kuwata
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006493:Heparin / Q000009:adverse effects / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D010314:Partial Thromboplastin Time; D011183:Postoperative Complications / Q000517:prevention & control; D006473:Postpartum Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology; D049590:Postpartum Period; D011247:Pregnancy; D012189:Retrospective Studies; D013927:Thrombosis / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D006493:Heparin