Analysis of risk factors and complications in postpartum lower extremity deep vein thrombosis patients at a single center

• Published in: Indian journal of vascular and endovascular surgery 2018-01, Vol.5 (1), p.22-25
• Main Authors: Jain, Piyushkumar, Vishnu, M, Lende, Vaibhav, Davra, Dharmesh, Sravan, C, Narkhede, Pravin, Vivekanand, Sumanthraj, Giirija, K, Suresh, K
• Format: Article
• Language: English
• Subjects: Abortion; Complications and side effects; Deep vein thrombosis; Health aspects; lower extremity postpartum deep vein thrombosis; Patient outcomes; postpartum deep vein thrombosis; Pregnant women; Risk factors; Venous thrombosis
• ISSN: 0972-0820; 2394-0999
• DOI: 10.4103/ijves.ijves_53_17

Objective: The objective of this study is to elucidate circumstances surrounding postpartum patients with lower extremity deep vein thrombosis (DVT) including demographics, risk factors, comorbidities, clinical presentation, and outcomes presenting to our tertiary care center. Introduction: Postpartum is a period of increased risk of venous thromboembolism (VTE). Several risk factors such as previous history of VTE, increased maternal age, varicose veins, mode of delivery, and family history of VTE have been suggested, but data supporting these are inconsistent. In this study, we have described circumstances surrounding postpartum lower extremity DVT including demographics, risk factors, comorbidities, and clinical presentation. Materials and Methods: In this retrospective study, all women with lower extremity duplex confirmed DVT during postpartum period, presented at Jain Institute of Vascular Sciences (JIVAS), Bengaluru, from January 2010 to December 2016 were enrolled. Baseline characteristics recorded were age of the patient, index lower extremity involved, segment of the vein involved and comorbidities. Risk factor evaluated were mode of delivery, history of varicose veins, previous history of thrombophilia, VTE, abortions/miscarriages, and tobacco use. Complications and treatments received in the hospital were documented. Results: Postpartum DVT was seen in 42 out of 1276 DVT patients (497 female patients) treated at JIVAS. The average age was 25.57 ± 5.73 years and left side (29 [69.04%]) being more commonly involved. Risk factors associated in patients were anemia 16 (38.09%), postlower segment cesarean section (LSCS) delivery 16 (38.09%) while tobacco use was seen in 2 (4.76%) patients, and varicose vein in 1 (2.38%). There were no patients with history of VTE, abortions, or thrombophilia. None of the patients had symptomatic pulmonary embolism (PE). All patients were treated with low-molecular-weight heparin and bridged to Vitamin K antagonists. Conclusion: The most common risk factors were anemia and post-LSCS delivery. There was no incidence of symptomatic PE or mortality.