Reduction in fatal pulmonary embolism and venous thrombosis by perioperative administration of low molecular weight heparin. Gynecological ward retrospective analysis.

OBJECTIVES

To compare the frequency of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing gynecological operations without low molecular weight heparin (LMWH) prophylaxis and those receiving such prophylaxis.

DESIGN

Retrospective, hospital record-based study.

MATERIAL AND

METHODS

About 1785 consecutive patients without LMWH prophylaxis and 1871 ones treated with nadroparin (Fraxiparine) 7500ICU s.c. 2h before the operation and repeated daily for 5-7 days or until the patient was fully mobile. DVT was diagnosed on the basis of clinical symptoms and ultrasound examination, and PE on clinical symptoms, gasometric data, electrocardiography and chest X-ray.

RESULTS

Among the patients without prophylaxis, four cases of PE occurred (0.22%), two fatal (0.11%), 13 cases of proximal DVT (0.72%) and 41 distal DVT complications (2.3%). In LMWH, group 3 proximal DVT (0.16%) and 18 distal DVT (0.96%) developed but there were no clinically expressed pulmonary embolism. According to the Fisher's exact test, the difference between the complications in the analyzed groups is significant P<0.05.

CONCLUSION

The perioperative applying of LMWH to prevent DVT in the patients operated on gynecologically is effective.