Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2020; 8(11): 2210-2218
Published online Jun 6, 2020. doi: 10.12998/wjcc.v8.i11.2210
Risk scores, prevention, and treatment of maternal venous thromboembolism
Wei Zhang, Jian Shen, Jing-Li Sun
Wei Zhang, Jian Shen, Jing-Li Sun, Department of Obstetrics and Gynecology, General Hospital of Northern Theater Command (Heping Campus), Shenyang 110000, Liaoning Province, China
Author contributions: All authors helped to perform the research; Zhang W wrote the manuscript, performed the procedures, and analysed and interpreted the data; Sun JL designed the research; Shen J collected the materials and clinical data.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the General Hospital of Northern Theater Command.
Informed consent statement: All patients gave informed consent to this study.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jing-Li Sun, MAMS, Chief Physician, Department of Obstetrics and Gynecology, General Hospital of Northern Theater Command (Heping Campus), No. 5, Guangrong Street, Heping District, Shenyang 110000, Liaoning Province, China. zg3416@sina.com
Received: January 20, 2020
Peer-review started: January 20, 2020
First decision: March 18, 2020
Revised: April 1, 2020
Accepted: May 1, 2020
Article in press: May 1, 2020
Published online: June 6, 2020
Processing time: 139 Days and 15.8 Hours
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: Pregnancy; Puerperium; Venous thromboembolism; Risk factors; Prevention; Anticoagulation

Core tip: Venous thromboembolism (VTE) is an acute type of non-suppurative venous inflammation with secondary intravascular thrombosis. The preventive treatment for pregnancy-related VTE in China is in its infancy, and there is no uniform or standardized industry guide. The standardized prevention and treatment of thrombosis in women during pregnancy represent an urgent issue faced by many Chinese doctors. In this study, a total of 7759 patients were investigated in terms of the status of VTE prophylactic treatment, with an aim to provide reference for the clinical prevention and treatment of this condition.