Risk factors in the thromboembolic diseases in puerperae
Keywords:
Thrombosis, Postpartum period, Cesarean section, Oral contraceptives.Abstract
Introduction: the thromboembolic disease is one of the main maternal morbidity and mortality causes in developed countries.Objective: to determine the risk factors of the thromboembolic disease during the postpartum period in puerperae with risk admitted at Abel Santamaria Cuadrado General Hospital from January to December 2011, in order to decrease incidence rate.
Material and method: an observational, longintudinal, analytic and applied study was carried out. Out of a target group of 5,598 pueperae, the final sample was ramdomly made up of 47 patients and 23 controls. The information was obtained from personal clinical records. To analyze the variants, we used percetage and odds ratio calculation, confidence interval, and the chi-squared test.
Results: the risk of thromboembolitic disease was irrespective of matern age and parity, but it was 23.57 times greater in those who use oral contraceptives, as well as in the 31.9% of the patients with venous insufficiency, and in the 73.4% of cesarean section patients and with superficial venous thrombosis, cases in which pain, edema and tachycardia predominated.
Conclusions: the thrombophilic state requires close watching in pospartum period, in order to detect the most frequent risk factors of the venous trhomboembolic disease (use of oral contraceptives, cesarean section patients and those with venous insufficiency), being the prophylactic treatment the cornerstone of trhombotic episodes prevention.
Downloads
References
1. Matos Borrego K, Díaz Raspall MR. Enfermedad Tromboembólica Venosa en gestantes y puérperas graves. MEDISAN. [revista en la Internet]. 2011; 15(5):626 [Consulta 20 julio 2012]; Disponible en: http://bvs.sld.cu/revistas/san/vol_15_5_11/san09511.htm
2. Fernández Alonso AM, Cruz Martínez M, Carretero Lucena P, Rodríguez García I, Garrigosa Romero L, Vizcaíno Martínez A. Eficacia de la tromboprofilaxis obstétrica. Rev. Obstet Ginecol Venez. [revista en la Internet] 2008 [Consulta 20 julio 2012)]; 68(4):215-221 Disponible en: http://www.scielo.org.ve/pdf/og/v68n4/art02.pdf
3. Nápoles Méndez D, Couto Núñez D. Enfermedad tromboembolica venosa en embarazo y puerperio. Enfoque de riesgo y diagnóstico. Artículo de revisión. MEDISAN. [revista en la Internet] 2011 noviembre. [Consulta 20 julio 2012]; 10 (15). Disponible en: http://scielo.sld.cu/scielo.php?pid=S102930192011001000012&script=sci_arttext
4. Gates S, Brocklehurst P, Davis LJ. Profilaxis para la enfermedad tromboembólica venosa en el embarazo y en el periodo postnatal temprano. La Biblioteca Cochrane Plus. [revista en la Internet] 2013 [Cited in 25 August 2012]; (5) Disponible en: http://www.update-software.com/BCP/BCPGetDocument.asp?DocumentID=CD001689
5. Puentes Madera IC, Barnés Domínguez JA. Epidemiología de la enfermedad tromboembólica venosa. Revista Cubana de Angiología y Cirugía Vascular. [revista en la Internet] 2013 [Consulta 10 enero 2012]; 14(S 13). Disponible en: http://bvs.sld.cu/revistas/ang/vol14_sup_13/ang0213sup.htm
6. Jackson E, Curtis KM, Gaffield ME. Risk of venous thromboembolism during the postpartum period: a systematic review. Obstet Gynecol. [Published online] 2011 Mar; [Cited in 25 August 2012]; 117(3):691-703. Available in: http://www.jbc.org/content/253/23/8583.full.pdf
7. Middeldorp S. How I treat pregnancy-related venous thromboembolism. Blood. [Published online] 2011 Sep [Cited in 25 August 2012]; 118(20):5394-400 Available in: http://bloodjournal.hematologylibrary.org/content/118/20/5394.full.pdf+html
8. James AH. Venous Thromboembolism in Pregnacy. Arterioscler Thromb Vasc Biol [Published online] 2009 [Cited in 12 September 2012]; 29:326-331. Available in: http://atvb.ahajournals.org/content/29/3/326.long
9. Bates S, Greer I, Pabinger I, Sofaer S, Hirsh J. Venous Thromboembolism, Thrombophilia, Antithrombotic Therapy and Pregnancy: American College of Chest Physicians Evidence Based Clinical Practice Guidelines. Chest. [Published online] 2008 [Cited in 12 September 2012]; 133:844S-886S Available in: http://journal.publications.chestnet.org/article.aspx?articleid=1085942
10. Rodger M. Evidence base for the management of venous thromboembolism in pregnancy. Hematology. [Published online] 2010 [Cited in 15 Oct 2012); 1: 173. Available in: http://asheducationbook.hematologylibrary.org/content/2010/1/173.full
11. ESC Guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). Eur Heart J. [Published online] 2011 Dec [Cited in 15 oct 2012]; 32(24):3147-97. Available in: http://eurheartj.oxfordjournals.org/content/32/24/3147.long
12. Tooher R, Gates S, Dowswell T, Davis LJ. Prophylaxis for venous thromboembolic disease in pregnancy and the early postnatal period. Cochrane Database of Systematic Reviews [Published online] 2010 [Cited in 25 oct 2012]. Available en: http://wrap.warwick.ac.uk/3357/1/WRAP_Gates_prophylaxis.pdf
13. Bahl V, Hu HM, Henke PK, Wakefield TW, Campbell DA Jr, Caprini JA. A validation study of a retrospective venous thromboembolism risk scoring method. Ann Surg. [Published online] 2010 Feb; [Cited in 25 oct 2012]; 251(2):344-50. Available in: http://www.acforum-excellence.org/sites/default/files/Bahl.Caprini.pdf
14. Julia Hippisley-Cox, Carol Coupland. Development and validation of risk prediction algorithm (QThrombosis) to estimate future risk of venous thromboembolism: prospective cohort study. [Published online] 2011 August 16. [Cited in 10 november 2012]; 343: d4656. Available in: http://www.bmj.com/content/343/bmj.d4656
15. Galanter WL, Thambi M, Rosencranz H, Shah B, Falck S, Lin F-J, et al. Effects of clinical decision support on venous thromboembolism risk assessment, prophylaxis, and prevention at a university teaching hospital. Am J Health Syst Pharm. [Published online] 2010 [Cited in 10 november 2012]; 67 (15) 1265-1273. Available in: http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=1568b6fd-73ab-4aec-9d94-69760731b00a%40sessionmgr15&vid=2&hid=26
16. Guía de Práctica Clínica Diagnóstico y tratamiento dela enfermedad tromboembolica venosa. México: Secretaria de Salud; 2012. [Published online]; Available en: http://www.cenetec.salud.gob.mx/descargas/gpc/CatalogoMaestro/437_GPC_Enf_troboembolica_venosa/GER_Enfermedad_tromboembxlica_
venosa.pdf [Cited in 20 november 2012]
17. Dresang L, Fontaine P, Leeman L, King V. Venous Thromboembolism during Pregnancy. Am Fam Physician [Published online] 2008 jun [Cited in 20 november 2012]; 15;77 (12):1709-1716 Available in: http://www.aafp.org/afp/2008/0615/p1709.html
18. Acuña A D, Sócrates Aedo M. Enfermedad tromboembolica venosa en embarazo y puerperio. Rev. Obstet. Ginecol. - Hosp. Santiago Oriente Dr. Luis Tisné Brousse [artículo en línea] 2012; [Consulta 20 diciembre 2012]; 7 (2) 83-100. Disponible en: http://www.revistaobgin.cl/files/pdf/023.pdf
19. Ramón E. Coronado Mestre, Luís Carmenate Martínez, Juan Manuel Rodríguez Hernández, Jorge Luís Toro Aguiar. Trombosis venosa profunda en pacientes embarazadas ingresadas en el hospital ginecoobstétrico "Dr. Eusebio Hernández", 2000_2005. Revista Cubana de Medicina Intensiva y Emergencias. [artículo en línea] 2008 [Consulta 20 diciembre 2012];7(2) Disponible en: http://bvs.sld.cu/revistas/mie/vol7_2_08/mie09208.htm
20. Rodríguez Roque María, Herrera Alonso Didiesdle, Sánchez Lozano Ada. Trombosis venosa en el puerperio. Presentación de un caso: bases bioquímicas y su aplicación en la enfermedad cerebrovascular isquémica. MediSur [revista en la Internet]. 2009 Jun [Consulta 20 diciembre 2012]; 7(3): 61-64. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727-897X2009000300009&lng=es
Published
How to Cite
Issue
Section
License
Authors who have publications with this journal agree to the following terms: Authors will retain their copyrights and grant the journal the right of first publication of their work, which will be publication of their work, which will be simultaneously subject to the Creative Commons Attribution License (CC-BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g.: deposit it in an institutional telematic archive or publish it in a volume). Likewise, and according to the recommendations of the Medical Sciences Editorial (ECIMED), authors must declare in each article their contribution according to the CRediT taxonomy (contributor roles). This taxonomy includes 14 roles, which can be used to represent the tasks typically performed by contributors in scientific academic production. It should be consulted in monograph) whenever initial publication in this journal is indicated. Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which may produce interesting exchanges and increase citations of the published work. (See The effect of open access). https://casrai.org/credit/
