Incidence of Pregnancy-Associated Venous Thromboembolism

Vijay Rajput; Huma Q. Rana

doi:10.7326/0003-4819-144-6-200603210-00018

Letters |21 March 2006

Incidence of Pregnancy-Associated Venous Thromboembolism

Vijay Rajput, MBBS; Huma Q. Rana, BA

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TO THE EDITOR:

Heit and colleagues' population-based study (1) identifies age and postpartum period as key issues in incidence of venous thromboembolism during and after pregnancy. In the past few decades, incidence of cesarean section in the United States has been 21% (2). The authors do not identify women undergoing cesarean sections as a separate high-risk group. A previous study (3) identified operative vaginal delivery, emergency cesarean section during labor, high body mass index, previous venous thromboembolism, and family history as major risk factors. In 1 small study, thromboembolism incidence was very low in women with no additional risk factors when the rate of cesarean sections was 20% (4). Although there is no consensus on prophylaxis after cesarean section, Heit and colleagues' study could have given more guidance for further research and clinical trials involving older women undergoing this procedure. The STOP CLOT Pilot Study (5), a phase III clinical trial, is now under way to assess the effectiveness and safety of low-molecular-weight heparin in women who are at moderate to high risk for venous thromboembolism after cesarean section.

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2006 American College of Physicians

Letters |21 March 2006

Incidence of Pregnancy-Associated Venous Thromboembolism

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Letters |21 March 2006

Incidence of Pregnancy-Associated Venous Thromboembolism

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