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CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2018; 40(03): 156-162
DOI: 10.1055/s-0037-1621742
Review Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Venous Thromboembolism and Route of Delivery – Review of the Literature

Tromboembolismo venoso e via de parto – revisão da literatura
Matheus Schimidt Evangelista
1   Faculdade de Medicina, Universidade Federal do Paraná, Curitiba, PR, Brazil
,
Karina Slompo
1   Faculdade de Medicina, Universidade Federal do Paraná, Curitiba, PR, Brazil
,
Jorge Rufino Ribas Timi
2   Division of Vascular Surgery, Department of Surgery, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, PR, Brazil
› Institutsangaben
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Publikationsverlauf

16. Oktober 2017

12. Dezember 2017

Publikationsdatum:
23. Februar 2018 (online)

   Lizenzen und Reprints

Abstract

Venous thromboembolism events are important causes of maternal death during pregnancy and the postpartum period worldwide. A review of the literature with the objective of evaluating venous thromboembolism events in the puerperium according to the route of delivery was performed through a bibliographic survey in the Medline, LILACS and Scielo databases. We observed that patients submitted to cesarean sections present a significantly higher risk of developing venous thromboembolism when compared with those who undergo spontaneous vaginal delivery. The pathophysiological bases for this difference were explored and described in this review, as well as the indications of prophylaxis and treatment. Doctors and health professionals must be continuously vigilant regarding this condition, since it is associated with high morbidity and mortality.

Resumo

Os eventos de tromboembolismo venoso são causas importantes de morte materna durante a gravidez e o período do pós-parto em todo o mundo. Foi realizada uma revisão da literatura com o objetivo de avaliar os eventos de tromboembolismo venoso no puerpério de acordo com a via de parto utilizada, por meio de uma pesquisa bibliográfica nas bases de dados Medline, LILACS e Scielo. Observou-se que as pacientes submetidas a cesariana apresentam um risco significativamente maior de desenvolver tromboembolismo venoso do que aquelas que se submetem a parto vaginal espontâneo. As bases fisiopatológicas desta diferença foram exploradas e descritas nesta revisão, bem como as indicações de profilaxia e tratamento. O alerta contínuo dos médicos e profissionais de saúde é necessário, uma vez que se trata de uma condição comum associada a alta morbidade e mortalidade.

Keywords

venous thromboembolism - venous thrombosis - natural childbirth - cesarean section - postpartum period

Palavras-chave

tromboembolia venosa - trombose venosa - parto normal - cesárea - período pós-parto
 

  • References

  • 1 Friedman AM, Ananth CV. Obstetrical venous thromboembolism: Epidemiology and strategies for prophylaxis. Semin Perinatol 2016; 40 (02) 81-86 . Doi: 10.1053/j.semperi.2015.11.011
    CrossrefPubMedSuche in Google Scholar
  • 2 Gibbons L, Belizán JM, Lauer JA, Betrán AP, Merialdi M, Althabe F. The Global Numbers and Costs of Additionally Needed and Unnecessary Caesarean Sections Performed per Year: Overuse as a Barrier to Universal Coverage: World Health Report. . Geneva: WHO; 2010
    Suche in Google Scholar
  • 3 Câmara R, Burlá M, Ferrari J. , et al. Cesarean section by maternal request. Rev Col Bras Cir 2016; 43: 301-310 . Doi: 10.1590/0100-69912016004002
    CrossrefPubMedSuche in Google Scholar
  • 4 Pandey S, Sharma J, Manandhar BL, Adhikari A. Acute pulmonary embolism after cesarean section. J Nepal Health Res Counc 2015; 13 (31) 241-244
    PubMedSuche in Google Scholar
  • 5 Boer K, den Hollander IA, Meijers JC, Levi M. Tissue factor-dependent blood coagulation is enhanced following delivery irrespective of the mode of delivery. J Thromb Haemost 2007; 5 (12) 2415-2420 . Doi: 10.1111/j.1538-7836.2007.02767.x
    CrossrefPubMedSuche in Google Scholar
  • 6 Andrade BAM, Gagliardo GI, Péret FJA. Tromboembolismo venoso no ciclo gravídico puerperal. Femina 2009; 37: 611-618
    PubMedSuche in Google Scholar
  • 7 Lee MY, Kim MY, Han JY, Park JB, Lee KS, Ryu HM. Pregnancy-associated pulmonary embolism during the peripartum period: An 8-year experience at a single center. Obstet Gynecol Sci 2014; 57 (04) 260-265 . Doi: 10.5468/ogs.2014.57.4.260
    CrossrefPubMedSuche in Google Scholar
  • 8 Blondon M, Harrington LB, Righini M, Boehlen F, Bounameaux H, Smith NL. Racial and ethnic differences in the risk of postpartum venous thromboembolism: a population-based, case-control study. J Thromb Haemost 2014; 12 (12) 2002-2009 . Doi: 10.1111/jth.12747
    CrossrefPubMedSuche in Google Scholar
  • 9 Pallasmaa N, Ekblad U, Gissler M. Severe maternal morbidity and the mode of delivery. Acta Obstet Gynecol Scand 2008; 87 (06) 662-668 . Doi: 10.1080/00016340802108763
    CrossrefPubMedSuche in Google Scholar
  • 10 Meng K, Hu X, Peng X, Zhang Z. Incidence of venous thromboembolism during pregnancy and the puerperium: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2015; 28 (03) 245-253 . Doi: 10.3109/14767058.2014.913130
    CrossrefPubMedSuche in Google Scholar
  • 11 Fardiazar Z, Hajizadeh K, Dinparvar S, Esmaili F. Thromboembolism and thrombosis during pregnancy and after delivery between 2009 and 2012 in Al-Zahra Educational Center. J Caring Sci 2014; 3 (03) 221-226 . Doi: 10.5681/jcs.2014.024
    PubMedSuche in Google Scholar
  • 12 Quinlan JD, Murphy NJ. Cesarean delivery: counseling issues and complication management. Am Fam Physician 2015; 91 (03) 178-184
    PubMedSuche in Google Scholar
  • 13 Fukuda W, Chiyoya M, Taniguchi S, Daitoku K, Fukuda I. Management of deep vein thrombosis and pulmonary embolism (venous thromboembolism) during pregnancy. Gen Thorac Cardiovasc Surg 2016; 64 (06) 309-314 . Doi: 10.1007/s11748-016-0635-2
    CrossrefPubMedSuche in Google Scholar
  • 14 Liu S, Liston RM, Joseph KS, Heaman M, Sauve R, Kramer MS. ; Maternal Health Study Group of the Canadian Perinatal Surveillance System. Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term. CMAJ 2007; 176 (04) 455-460 . Doi: 10.1503/cmaj.060870
    CrossrefPubMedSuche in Google Scholar
  • 15 Liu S, Heaman M, Joseph KS. , et al; Maternal Health Study Group of the Canadian Perinatal Surveillance System. Risk of maternal postpartum readmission associated with mode of delivery. Obstet Gynecol 2005; 105 (04) 836-842 . Doi: 10.1097/01.AOG.0000154153.31193.2c
    CrossrefPubMedSuche in Google Scholar
  • 16 Sharma R, Atkin H, Mackillop L, Paterson-Brown S. Assessment of the mobility of mothers postpartum to identify those at greatest risk of venous thromboembolism. J Obstet Gynaecol 2012; 32 (05) 461-463 . Doi: 10.3109/01443615.2012.676694
    CrossrefPubMedSuche in Google Scholar
  • 17 Kamilya G, Seal SL, Mukherji J, Bhattacharyya SK, Hazra A. Maternal mortality and cesarean delivery: an analytical observational study. J Obstet Gynaecol Res 2010; 36 (02) 248-253 . Doi: 10.1111/j.1447-0756.2009.01125.x
    CrossrefPubMedSuche in Google Scholar
  • 18 Atalla RK, Thompson JR, Oppenheimer CA, Bell SC, Taylor DJ. Reactive thrombocytosis after caesarean section and vaginal delivery: implications for maternal thromboembolism and its prevention. BJOG 2000; 107 (03) 411-414 . Doi: 10.1111/j.1471-0528.2000.tb13239.x
    CrossrefPubMedSuche in Google Scholar
  • 19 Tepper NK, Boulet SL, Whiteman MK. , et al. Postpartum venous thromboembolism: incidence and risk factors. Obstet Gynecol 2014; 123 (05) 987-996 . Doi: 10.1097/AOG.0000000000000230
    CrossrefPubMedSuche in Google Scholar
  • 20 Sénat MV, Sentilhes L, Battut A. , et al. Postpartum practice: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF). Eur J Obstet Gynecol Reprod Biol 2016; 202: 1-8 . Doi: 10.1016/j.ejogrb.2016.04.032
    CrossrefPubMedSuche in Google Scholar
  • 21 Ismail SK, Norris L, Muttukrishna S, Higgins JR. Thrombin generation post elective caesarean section: effect of low molecular weight heparin. Thromb Res 2012; 130 (05) 799-803 . Doi: 10.1016/j.thromres.2012.01.008
    CrossrefPubMedSuche in Google Scholar
  • 22 Saha P, Stott D, Atalla R. Haemostatic changes in the puerperium ‘6 weeks postpartum’ (HIP Study) - implication for maternal thromboembolism. BJOG 2009; 116 (12) 1602-1612 . Doi: 10.1111/j.1471-0528.2009.02295.x
    CrossrefPubMedSuche in Google Scholar
  • 23 Kobayashi H, Reid G, Hadfield M. Effects of vaginal delivery, cesarean section and exposure to labor on endothelial function of pregnant women. Thromb Res 2014; 134 (05) 1004-1007 . Doi: 10.1016/j.thromres.2014.08.029
    CrossrefPubMedSuche in Google Scholar
  • 24 Usluoğullari B, Kaygusuz I, Simavli S, Eser A, Inegol Gumus İ. Effects of cesarean section on mean platelet volume. Platelets 2015; 26 (07) 657-660 . Doi: 10.3109/09537104.2014.974152
    CrossrefPubMedSuche in Google Scholar
  • 25 Heyl PS, Sappenfield WM, Burch D, Hernandez LE, Kavanaugh VM, Hill WC. Pregnancy-related deaths due to pulmonary embolism: findings from two state-based mortality reviews. Matern Child Health J 2013; 17 (07) 1230-1235 . Doi: 10.1007/s10995-012-1117-5
    CrossrefPubMedSuche in Google Scholar
  • 26 Clark SL, Belfort MA, Dildy GA, Herbst MA, Meyers JA, Hankins GD. Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. Am J Obstet Gynecol 2008; 199 (01) 36.e1-36.e5 , discussion 91–92, e7–e11. Doi: 10.1016/j.ajog.2008.03.007
    CrossrefPubMedSuche in Google Scholar
  • 27 Palmerola KL, Brock CO, D'Alton ME, Friedman AM. Compliance with mechanical venous thromboproembolism prophylaxis after cesarean delivery. J Matern Fetal Neonatal Med 2016; 29 (19) 3072-3075 . Doi: 10.3109/14767058.2015.1118453
    CrossrefPubMedSuche in Google Scholar
  • 28 Freedman RA, Bauer KA, Neuberg DS, Zwicker JI. Timing of postpartum enoxaparin administration and severe postpartum hemorrhage. Blood Coagul Fibrinolysis 2008; 19 (01) 55-59 . Doi: 10.1097/MBC.0b013e3282f185dd
    CrossrefPubMedSuche in Google Scholar
  • 29 Alalaf SK, Jawad RK, Muhammad PR, Ali MS, Al Tawil NG. Bemiparin versus enoxaparin as thromboprophylaxis following vaginal and abdominal deliveries: a prospective clinical trial. BMC Pregnancy Childbirth 2015; 15: 72 . Doi: 10.1186/s12884-015-0515-2
    CrossrefPubMedSuche in Google Scholar
  • 30 James A. ; Committee on Practice Bulletins—Obstetrics. Practice bulletin no. 123: thromboembolism in pregnancy. Obstet Gynecol 2011; 118 (03) 718-729 . Doi: 10.1097/AOG.0b013e3182310c4c
    Suche in Google Scholar
  • 31 Harris SA, Velineni R, Davies AH. Inferior vena cava filters in pregnancy: a systematic review. J Vasc Interv Radiol 2016; 27 (03) 354-60.e8 . Doi: 10.1016/j.jvir.2015.11.024
    CrossrefPubMedSuche in Google Scholar
  • 32 Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos AM, Vandvik PO. VTE, thrombophilia, antithrombotic therapy, and pregnancy: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2012; 141: e691S-e6736 . Doi: 10.1378/chest.11-2300
    CrossrefPubMedSuche in Google Scholar
  • 33 Kearon C, Akl EA, Ornelas J. , et al. Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report. Chest 2016; 149 (02) 315-352 . Doi: 10.1016/j.chest.2015.11.026
    CrossrefPubMedSuche in Google Scholar
  • 34 Srinivas BC, Patra S, Nagesh CM, Reddy B, Manjunath CN. Catheter-directed thrombolysis in management of postpartum lower limb deep venous thrombosis - A case series. Indian Heart J 2015; 67 (Suppl. 03) S67-S70 . Doi: 10.1016/j.ihj.2015.08.002
    CrossrefPubMedSuche in Google Scholar
  • 35 Garcia SAL, Lippi UG, Garcia SA. O parto assistido por enfermeira obstetra: perspectivas e controvérsias. Rev Bras Promoç Saúde 2010; 23: 380-388 . Doi: 10.5020/2041
    PubMedSuche in Google Scholar