INCIDENCE OF DEEP VEIN THROMBOSIS (DVT) IN PREGNANT AND POSTPARTUM PATIENTS WITH HIGH VENOUS THROMBOEMBOLISM (VTE) SCORES
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Keywords
Deep Venous Thrombosis, Venous Thromboembolism, Postpartum
Abstract
Background: About 1.2 pregnancies are affected by venous thromboembolism (VTE). In countries with high incomes, thrombosis and thromboembolism are major causes of mortality among mothers. In Ireland, venous thromboembolism (VTE), which includes both pulmonary embolism (PE) and deep vein thrombosis (DVT), is the main reason for sudden maternal mortality during the first six weeks following childbirth
Objectives: To find out the incidence of Incidence of Deep Vein Thrombosis (DVT) in Pregnant and Postpartum Patients with High Venous Thromboembolism (VTE) Scores.
Methodology: This cross-sectional study examined the incidence of Deep Vein Thrombosis (DVT) in pregnant and postpartum women at Letterkenny University Hospital from March 2021 to march 2023. Targeting females with high Venous Thromboembolism (VTE) risk scores, the study used probability sampling to select participants from medical records and antenatal clinics. Data was collected from medical record reviews, covering demographics, obstetric and medical history, VTE risk factors, and comorbidities. Diagnostic methods included Doppler ultrasound and CT Pulmonary Angiography (CTPA). Thromboprophylaxis use, adherence, and follow-up were also recorded. Data analysis with SPSS version 24 involved descriptive statistics and chi-square tests to assess DVT incidence and its associations with various factors. Ethical approval and informed consent were obtained, ensuring the study adhered to ethical standards.
Results: The study included 200 females aged 23-46 years (mean age 37±3.5 SD), with 77.5% over 35 years. Ethnically, 97.5% were Irish and 2.5% from other ethnicities. Most had high gravidity (95.5%) and parity (67%), with 95% having no prior VTE history. BMI ranged from 21 to 51.54 (mean 35.72±11 SD). Risk factors for VTE included smoking (7.5%), varicose veins (7.5%), and phlebitis (4%). Gestational diabetes mellitus was the most common comorbidity (22%), followed by essential hypertension (9.5%) and pregnancy-induced hypertension (7%). Only 1.5% of participants developed DVT, diagnosed via Doppler ultrasound or CT Pulmonary Angiography.
Thromboprophylaxis was administered to 91% (INNOHEP) and 7.5% (CLEXANE), with high adherence (93.5%). Follow-up varied, with most having stable conditions and no significant changes in VTE risk status.
Conclusion: The incidence of DVT among pregnant and postpartum patients with high VTE is low. Despite the presence of various risk factors and co morbidities, the overall incidence of DVT remains low, possibly due to effective thromboprophylaxis. The risk factors and comorbidities did not significantly elevate DVT incidence. Majority of the participants adhered to their prescribed thromboprophylaxis regimen. These findings highlight the effectiveness thromboprophylaxis strategies in reducing DVT incidence among high risk pregnant and post partum patients.
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Alveena Khan
Registrar, Obstetrics and Gynaecology, Letterkenny University Hospital, Ireland
Aqsa Arbab Khan
Senior House Officer, Obstetrics and Gynaecology, Letterkenny University Hospital, Ireland
Shima Algasim Abbas Alhindi
Senior House Officer, Obstetrics and Gynaecology, Letterkenny University Hospital, Ireland
Farhat Shireen
Senior Registrar, Obstetrics and Gynaecology, Letterkenny University Hospital, Ireland
Foo Kok Mak
Consultant, Obstetrics and Gynaecology, Letterkenny University Hospital, Ireland