Risk assessment of maternal venous thromboembolism in antenatal and postnatal period; a cross-sectional, descriptive study

Abstract

Background: Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is quite common disease and is associated with substantial morbidity and mortality. According to report on mortality by Iraqi Ministry of Health, maternal pulmonary embolism was the second most common cause among the direct causes of maternal deaths. We assessed the risk of thromboembolism during pregnancy and puerperium.

Methodology: This cross-sectional, descriptive study was conducted in selected primary healthcare centers in Al-Najaf during the period from April 01, 2018 to December 01, 2018. We selected 236 women (pregnant and postpartum) by convenient sampling method. All pregnant and postpartum women reporting to the hospital constituted the target population of the study.

Results: Risk assessment in antenatal group was low in 119 (74.4%) women, intermediate in 40 (25.0%) and high in one (0.6%) woman, while in postnatal group it was low in 50 (65.8%), intermediate in 25 (32.9%) and high in one woman (1.3%). According to these findings, the frequency of low risk was higher in antenatal group compared to postnatal group, while the frequency of intermediate and high risks was higher in postnatal than antenatal group; however, the differences were not significant statistically, (P > 0.05).

Conclusion: Women have more high and intermediate risk of thromboembolism in the postnatal period than antenatal period. The significant risk factors are multiple parity, middle age, gross obesity, medical comorbidities, preeclampsia, current systemic infection, elective cesarean section and hyperemesis gravidarum with dehydration.