Document Detail

Future research needs for venous thrombo-embolic disease in obstetrics and gynaecology.
MedLine Citation:
PMID:  9488794     Owner:  NLM     Status:  MEDLINE    
The clinical management of thrombo-embolic disease in obstetrics and gynaecology is hampered by the paucity of firm evidence on which to base clinical decisions. This is particularly so in obstetrics where there have been no randomized controlled trials of thromboprophylaxis in pregnancy or the puerperium of sufficient size to detect differences in the incidence of clinical thrombo-embolic events. The incidence of osteoporosis and bleeding complications associated with heparin have not been precisely defined in pregnancy and we are already using low-molecular-weight heparin in place of unfractionated heparin when we do not know whether either heparin is preferable to nothing. In gynaecology, the various thromboprophylactic modalities for use in relation to surgery need to be compared. The small randomized comparisons that have been performed suggest that relatively non-invasive procedures may be just as effective as heparin in preventing thrombo-embolism without the associated complications. Recent controversies concerning the effect of the OCP and HRT on the risk of thrombo-embolic disease indicate that the present methods we use to evaluate these interventions needs to be urgently addressed so that safety rather than efficacy becomes the principle outcome.
P Brocklehurst
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Baillière's clinical obstetrics and gynaecology     Volume:  11     ISSN:  0950-3552     ISO Abbreviation:  Baillieres Clin Obstet Gynaecol     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1998-03-16     Completed Date:  1998-03-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8710782     Medline TA:  Baillieres Clin Obstet Gynaecol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  601-10     Citation Subset:  IM    
National Perinatal Epidemiology Unit, Radcliffe Infirmary, Oxford, UK.
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MeSH Terms
Anticoagulants / therapeutic use
Cesarean Section
Contraceptives, Oral, Hormonal / adverse effects
Estrogen Replacement Therapy / adverse effects
Heparin / therapeutic use
Pregnancy Complications, Cardiovascular / drug therapy*,  etiology,  prevention & control
Thromboembolism / drug therapy*,  etiology,  prevention & control
Thrombophilia / complications
Reg. No./Substance:
0/Anticoagulants; 0/Contraceptives, Oral, Hormonal; 9005-49-6/Heparin

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