Sharma Sanjay, Monga Deepika
Ballarat Health Services, Ballarat, Victoria, Australia.
Aust N Z J Obstet Gynaecol. 2008 Feb;48(1):44-9. doi: 10.1111/j.1479-828X.2007.00799.x.
There is a strong recommendation for post-partum thromboprophylaxis following emergency caesarean sections, particularly in overweight women, and following prolonged labour.
To analyse the incidence and epidemiological factors associated with antepartum and post-partum venous thromboembolism in a large Victorian health service.
A retrospective study of all 6987 women delivering at Ballarat Health Services between March 1999 and June 2006. Case notes of women with confirmed venous thromboembolism during this period were subjected to detailed analysis. The data were analysed for possible risk factors, the timing of thromboembolism in relation to the pregnancy and any correlation with thromboprophylaxis, if administered.
The rate of venous thromboembolism was 1.14 per 1000 deliveries, with risk factors of age > 30 (100%), obesity (75%), previous history of thromboembolism (62.5%) and caesarean section (37.5%). Majority of cases were diagnosed in first trimester (62.5%), and in the right lower limb (75%). None of the patients had been given thromboprophylaxis.
While the incidence and risk factors were similar to those generally quoted, a much higher incidence was found in early pregnancy, and in the right lower limb. The importance of meticulous screening for risk factors in early pregnancy cannot be overemphasised.
强烈建议在急诊剖宫产术后进行产后血栓预防，尤其是超重女性以及产程延长后。
分析在一家大型维多利亚州医疗服务机构中，与产前和产后静脉血栓栓塞相关的发病率及流行病学因素。
对1999年3月至2006年6月期间在巴拉瑞特医疗服务机构分娩的所有6987名女性进行回顾性研究。对在此期间确诊为静脉血栓栓塞的女性病历进行详细分析。分析数据以找出可能的风险因素、血栓栓塞与妊娠的时间关系以及与所给予的血栓预防措施（若有）的任何相关性。
静脉血栓栓塞发生率为每1000例分娩1.14例，风险因素包括年龄>30岁（100%）、肥胖（75%）、既往血栓栓塞史（62.5%）和剖宫产（37.5%）。大多数病例在孕早期被诊断（62.5%），且发生在右下肢（75%）。无一例患者接受过血栓预防。
虽然发病率和风险因素与一般引用的相似，但在孕早期以及右下肢发现了更高的发病率。对孕早期风险因素进行细致筛查的重要性再怎么强调也不为过。
