title: The "Pregnancy Health-care Program" for the prevention of venous thromboembolism in pregnancy.
abstract: Venous thromboembolism (VTE), i.e., deep vein thrombosis and pulmonary embolism, are among the main causes of morbidity and mortality in pregnancy with an estimated incidence of 1 per thousand women years. Recommendations on antithrombotic prophylaxis are weak. The aim of the "Pregnancy Health-care Program" (PHP) was to evaluate the individual risk of VTE in a cohort of pregnant women, and manage them with the aim of reducing the rate of VTE. The study was conducted from Jan 2008 to Dec 2010 in the hospital and obstetrical outclinics in Cremona, Italy, and included 1,787 pregnant women who received clinical observation (n = 1,197), above-knee compression stockings (n = 437) or compression stockings and low-molecular-weight heparin (LMWH) (n = 85) depending on their individual VTE risk, evaluated with a risk score (0.5-3.0) derived from the relative risk estimates of a number of risk factors. Visits were scheduled at the end of each trimester and at hospital discharge after delivery. No VTE occurred, but one superficial vein thrombosis was observed 3 days after vaginal delivery in a woman who received clinical observation (0.6 per thousand). No bleeding was observed in LMWH users. The PHP based on stratification of individual VTE risk resulted in a low incidence of VTE events.
authors: Hemostasis and Thrombosis Center, Clinical Pathology Department, AO Istituti Ospitalieri di Cremona, Viale Concordia 1, 26100, Cremona, Italy, s.testa@ospedale.cremona.it.
authors: Sophie
authors: S
authors: Testa
authors: Serena M
authors: SM
authors: Passamonti
authors: Oriana
authors: O
authors: Paoletti
authors: Paolo
authors: P
authors: Bucciarelli
authors: Enrica
authors: E
authors: Ronca
authors: Aldo
authors: A
authors: Riccardi
authors: Alberto
authors: A
authors: Rigolli
authors: Anke
authors: A
authors: Zimmermann
authors: Ida
authors: I
authors: Martinelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007558:Italy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D054556:Venous Thromboembolism / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D006493:Heparin