Thromboprophylaxis with low-molecularweight heparin after cesarean delivery

摘要

Venous thromboembolism (VTE) is the leading cause of maternal mortality and morbidity in the developed world. Pregnancy is associated with an up to 10-fold increase in the risk of VTE compared with non-pregnant women, with the highest incidence during the post-partum period. Cesarean delivery further raises the incidence of VTE by up to 22 times with the highest risk reported after an emergency procedure. In the mean time, a continuous rise in the use of cesarean delivery has been widely reported in developed countries (in the United States nearly 30% of births were delivered by this route in 2004). Nevertheless, there is some evidence that thromboprophylaxis using unfraction-ated heparin after caesarean delivery was potentially more harmful than beneficial. However, this may be due to negative side-effects of unfractionated heparin such as heparin-induced thrombocytopenia and relatively high rates of bleeding complications.