Risk scores, prevention, and treatment of maternal venous thromboembolism

Wei Zhang; Jian Shen; Jing-Li Sun

doi:10.12998/wjcc.v8.i11.2210

Risk scores, prevention, and treatment of maternal venous thromboembolism

World J Clin Cases. 2020 Jun 6;8(11):2210-2218. doi: 10.12998/wjcc.v8.i11.2210.

Authors

Wei Zhang¹, Jian Shen¹, Jing-Li Sun²

Affiliations

¹ Department of Obstetrics and Gynecology, General Hospital of Northern Theater Command (Heping Campus), Shenyang 110000, Liaoning Province, China.
² Department of Obstetrics and Gynecology, General Hospital of Northern Theater Command (Heping Campus), Shenyang 110000, Liaoning Province, China. zg3416@sina.com.

Abstract

Background: At present, the preventive treatment for pregnancy-related venous thromboembolism (VTE) in China is in its infancy, and there is no uniform or standardized industry guide. Drug prevention and treatment of pregnancy-related VTE rely highly on foreign guidelines; however, due to the differences in ethnicity and national conditions, there are many controversies over the indications for drug treatment, drug selection, and dose selection for anticoagulant therapy.

Aim: To investigate the risk scores, prevention, and treatment of maternal VTE to promote the prevention and standardized treatment of maternal thrombosis.

Methods: A retrospective analysis was performed on 7759 patients who gave birth at our hospital from June 2018 to June 2019. Risk factors for pregnancy-related VTE, prenatal and postpartum VTE risk scores, prophylactic anticoagulant therapy, side effects after medication, and morbidity were analysed.

Results: The risk factors for VTE were mainly caesarean delivery, obesity, and advanced maternal age. Regarding pregnancy-related VTE risk scores, there were 7520 patients in the low-risk group with a prenatal score < 3 points and 239 in the high-risk group with a score ≥ 3, and 44 patients received drug prevention and treatment during pregnancy. There were 4223 patients in the low-risk group with a postpartum score < 2 points and 3536 in the high-risk group with a score ≥ 2 points, and 824 patients received drug prevention and treatment for 10 d. Among the patients who did not present with VTE before delivery, we found one case each of pulmonary embolism secondary to lower extremity venous thrombosis, intracranial venous sinus thrombosis, and asymptomatic lower extremity venous thrombosis during the postpartum follow-up.

Conclusion: VTE poses a serious threat to maternal safety, and the society should increase its vigilance against pregnancy-related VTE.

Keywords: Anticoagulation; Pregnancy; Prevention; Puerperium; Risk factors; Venous thromboembolism.