title: The effects of intermittent pneumatic compression during cesarean delivery on fibrinolysis.
abstract: OBJECTIVE
  Pregnancy is associated with increased risk for thromboembolic events. Intermittent pneumatic compression (IPC) devices are the method of thromboprophylaxis in a nonpregnant population. The aim of this study was to examine the effects of IPC on markers of fibrinolysis during cesarean delivery.
  
  
  METHODS
  We conducted a randomized controlled trial from April 2009 to March 2010 of women undergoing scheduled elective cesarean delivery. Forty-nine women were randomized to IPCs or usual care. All participants had three blood samples obtained: (1) baseline, (2) 1 hour after randomization, and (3) 30 minutes after cesarean delivery. Tissue-type plasminogen activator (tPA), urokinase-type plasminogen activator (uPA), thrombin-antithrombin complex (TAT), plasminogen activator inhibitor-1 (PAI-1), and plasminogen activator inhibitor-2 (PAI-2) levels were analyzed in each sample using an enzyme-linked immunosorbent assay. Statistical analysis was performed using repeated measures two-way analysis of variance with α = 0.05.
  
  
  RESULTS
  There was a time-dependent change in tPA, uPA, and PAI-1 levels following delivery but no difference in TAT and PAI-2 levels with time. There were no differences between women randomized to IPCs or usual care.
  
  
  CONCLUSIONS
  Markers of fibrinolysis were not significantly altered by IPCs in this study of low-risk pregnant women. Further research regarding the mechanism and efficacy of IPCs in pregnant women is warranted.
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
authors: Keisha L B
authors: KL
authors: Reddick
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
authors: Michael P
authors: MP
authors: Smrtka
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
authors: Chad A
authors: CA
authors: Grotegut
authors: Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia.
authors: Andra H
authors: AH
authors: James
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
authors: Leo R
authors: LR
authors: Brancazio
authors: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
authors: Geeta K
authors: GK
authors: Swamy
mesh_terms: D000328:Adult; D000990:Antithrombin III; D015415:Biomarkers / Q000097:blood; D002585:Cesarean Section / Q000379:methods*; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D005342:Fibrinolysis; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D010447:Peptide Hydrolases / Q000097:blood; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D017396:Plasminogen Activator Inhibitor 2 / Q000097:blood; D011247:Pregnancy; D010959:Tissue Plasminogen Activator / Q000097:blood; D014568:Urokinase-Type Plasminogen Activator / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; D017395:Plasminogen Activator Inhibitor 1; D017396:Plasminogen Activator Inhibitor 2; C046193:antithrombin III-protease complex; D000990:Antithrombin III; D010447:Peptide Hydrolases; D010959:Tissue Plasminogen Activator; D014568:Urokinase-Type Plasminogen Activator