A Study on Risk Factors for Venous Thromboembolism and the Requirement of Thromboprophylaxis in Pregnancy and Postpartum Period in a Tertiary Care Centre in South Asian Country: A Cross Sectional Study  

作　　者：P. L. A. Sirisena S. N. Samarakkody B. Subhani D. Gunawardana M. A. K. Perera C. Rathnayake P. L. A. Sirisena;S. N. Samarakkody;B. Subhani;D. Gunawardana;M. A. K. Perera;C. Rathnayake(De Soysa Hospital for Women, Colombo, Sri Lanka;Colombo South Teaching Hospital, Colombo, Sri Lanka;National Hospital of Sri Lanka, Colombo, Sri Lanka;Provincial Department of Health Services, Central Province, Kandy, Sri Lanka;Department of Obstetrics and Gynaecology, University of Peradeniya, Kandy, Sri Lanka)

机构地区：[1]De Soysa Hospital for Women, Colombo, Sri Lanka [2]Colombo South Teaching Hospital, Colombo, Sri Lanka [3]National Hospital of Sri Lanka, Colombo, Sri Lanka [4]Provincial Department of Health Services, Central Province, Kandy, Sri Lanka [5]Department of Obstetrics and Gynaecology, University of Peradeniya, Kandy, Sri Lanka

出　　处：《Open Journal of Obstetrics and Gynecology》2023年第3期403-413,共11页妇产科期刊（英文）

摘　　要：Introduction: Thrombosis is a major cause of maternal death worldwide. During pregnancy, the risk of venous thromboembolism (VTE) increases fourfold to five-fold and contributes towards maternal morbidity and mortality. Sri Lanka does not have a proper assessment tool to detect and manage it in the antenatal care. Objectives: To identify risks factors for VTE among pregnant mothers, postpartum mothers according to RCOG (Royal College of Obstetricians) risk categorization and to assess the requirement of thromboprophylaxis. Method: A cross sectional study was conducted at the antenatal clinics and obstetrics and gynaecology wards (ward 2, 5, 8) of De Soysa Hospital for Women in 2021. Obstetric thromboprophylaxis risk assessment tool recommended by the RCOG was used for the risk assessment of pregnant mothers during the antenatal and postpartum period. Results: In antenatal period, obesity (BMI > 35), age more than 35 years and parity more than 3 were the commonest risk factors. Out of 404 mothers, 67.33% did not have any risk factors. Among others, 18.56%, 0.40%, 2.72%, 0.99% had a score of 1, 2, 3 and 4 respectively. Patients with intermediate (0.99%) and high risk (2.72%) were commenced on thromboprophylaxis from 28 weeks. The low-risk category was not started on any treatment (28.96%, n = 97). Approximately 96% of mothers did not require any thromboprophylaxis during antenatal period. Another 404 postnatal mothers were recruited for the study group. Elective caesarean section and caesarean section during labour were the main risks identified other than pre-existing antenatal risks. 39.95 % of mothers did not have any risk factors and 37.22% of mothers had a score of 1. Conclusions: VTE risk assessment tool can be implemented at national level to detect patients at risk of VTE and improve maternal care.Introduction: Thrombosis is a major cause of maternal death worldwide. During pregnancy, the risk of venous thromboembolism (VTE) increases fourfold to five-fold and contributes towards maternal morbidity and mortality. Sri Lanka does not have a proper assessment tool to detect and manage it in the antenatal care. Objectives: To identify risks factors for VTE among pregnant mothers, postpartum mothers according to RCOG (Royal College of Obstetricians) risk categorization and to assess the requirement of thromboprophylaxis. Method: A cross sectional study was conducted at the antenatal clinics and obstetrics and gynaecology wards (ward 2, 5, 8) of De Soysa Hospital for Women in 2021. Obstetric thromboprophylaxis risk assessment tool recommended by the RCOG was used for the risk assessment of pregnant mothers during the antenatal and postpartum period. Results: In antenatal period, obesity (BMI > 35), age more than 35 years and parity more than 3 were the commonest risk factors. Out of 404 mothers, 67.33% did not have any risk factors. Among others, 18.56%, 0.40%, 2.72%, 0.99% had a score of 1, 2, 3 and 4 respectively. Patients with intermediate (0.99%) and high risk (2.72%) were commenced on thromboprophylaxis from 28 weeks. The low-risk category was not started on any treatment (28.96%, n = 97). Approximately 96% of mothers did not require any thromboprophylaxis during antenatal period. Another 404 postnatal mothers were recruited for the study group. Elective caesarean section and caesarean section during labour were the main risks identified other than pre-existing antenatal risks. 39.95 % of mothers did not have any risk factors and 37.22% of mothers had a score of 1. Conclusions: VTE risk assessment tool can be implemented at national level to detect patients at risk of VTE and improve maternal care.

关 键 词：Venous Thromboembolism POSTPARTUM THROMBOPROPHYLAXIS Cross-Sectional Study Maternal Morbidity and Mortality 

分 类 号：R73[医药卫生—肿瘤]