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
ARTICLE HIGHLIGHTS
Research background

The preventive treatment for pregnancy-related venous thromboembolism (VTE) in China is in its infancy. There is no uniform or standardized industry guide. 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.

Research motivation

The standardized prevention and treatment of thrombosis in women during pregnancy represent an urgent issue.

Research objectives

In this study, the authors aimed to investigate the risk scores, prevention, and treatment of maternal VTE to promote the prevention and standardized treatment of maternal thrombosis.

Research methods

Totally 7759 patients who gave birth were retrospectively analysed. The risk factors for pregnancy-related VTE, prenatal and postpartum VTE risk scores, prophylactic anticoagulant therapy, side effects after medication, and morbidity were analysed.

Research results

The VTE risk factors were mainly caesarean delivery, obesity, and advanced maternal age. Among the patients who did not present with VTE before delivery, the authors 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.

Research conclusions

Among 7759 pregnant women, approximately 1/30 (prenatal) and 1/2 (postpartum) belonged to the high-risk group of pregnancy-related VTE, which is a subject of clinical intervention. Due to poor patient compliance, 18.41% (prenatal) and 23.30% (postpartum) of the high-risk patients received drug prophylaxis and treatment. VTE poses a serious threat to maternal safety, and the society should increase its vigilance against pregnancy-related VTE.

Research perspectives

Early detection of high-risk groups for VTE should be performed, and preventive anticoagulant therapy should be promptly implemented to reduce the incidence of pregnancy-related VTE and reduce maternal mortality.