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How do we manage VTE in pregnancy? -A Retrospective Review of the Practice of Diagnosing and Managing Pregnancy Related Venous Thromboembolism at Two Major Hospitals in Australia and New Zealand.
MedLine Citation:
PMID:  22755545     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:  North American and European literature suggest that the incidence rate for pregnancy related VTE ranges from 0.5 to 2 per 1000 pregnancies. However, there is a paucity of data regarding pregnancy related VTE in Australia and New Zealand. Aims:  To define the epidemiology, management and adverse effects of pregnancy related VTE in Australia and New Zealand. Method:  Retrospective chart review of pregnant patients with objectively diagnosed pregnancy related VTE at Monash Medical Centre and the North Shore Hospital from January 2007 to March 2011. Results:  Sixty women with VTE were identified, 31 and 29 in the antepartum and postpartum, respectively. VTE occurred as early as eight weeks of gestation. There was a trend towards higher proportion of PE in the postpartum period. Most antenatal patients were started on enoxaparin and dosed according to weight at diagnosis. A wide variability in maintenance dosing strategies was observed. Three (5%, CI: 1% to 14%) patients suffered major bleeds, all occurring postpartum. Recurrences occurred in two postpartum patients who received a truncated course of enoxaparin for distal DVT. Although more women had an induction of labour, this did not translate into an increased Caesarean section rate. Conclusion:  The epidemiology of pregnancy related VTE is similar to that of other developed countries. All three bleeding events occurred in the immediate postpartum setting highlighting the need for caution at this critical time. VTE recurrences occurred in those women with postpartum distal DVT treated with an abbreviated course of enoxaparin.
Authors:
Noel Chan; Eileen Merriman; Sarah Hyder; Tracey Woulfe; Huyen Tran; Sanjeev Chunilal
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-4
Journal Detail:
Title:  Internal medicine journal     Volume:  -     ISSN:  1445-5994     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101092952     Medline TA:  Intern Med J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Internal Medicine Journal © 2012 Royal Australasian College of Physicians.
Affiliation:
Department of Clinical Haematology, Monash Medical Centre, 246 Clayton Road, Clayton 3168, Australia Department of Haematology, North Shore Hospital, WDHB, 124 Shakespeare Road, Takapuna, Auckland City 0622, New Zeala.
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