Safety of Routine Use of Pharmacological Thromboprophylaxis in Post Cesarean Section Patients [18C]

INTRODUCTION: To establish the safety of routine use of heparin and low molecular weight heparin (LMWH) for routine in post cesarean section thromboprophylaxis. METHODS: A case control study of all cesarean sections performed at Queens Hospital Center, NY, 1/2010 - 12/2013. 1127 patients were studied in which 924 patients were included in the study. Control group: did not receive pharmacological thromboprophylaxis - 481 patients. Case study group: received routine chemoprophylaxis - 444 patient. The primary outcomes included complications of pharmacological thromboprophylaxis: wound hematomas, secondary postpartum hemorrhage, thrombocytopenia and hypersensitivity. Secondary outcomes: other wound complications, not hematomas, and efficacy of routine use of Heparin or LMWH in preventing venous thromboembolism (VTE). RESULTS: There was no statistically significant increase in adverse events of grade 2 or more following routine use of heparin or LMWH after cesarean section compared to the control group. 4 cases of wound hematomas were detected in both groups (P: 0.57). No hypersensitivity or delayed postpartum hemorrhage were detected in the case study group. There were 4 cases of thrombocytopenia in the case study group in which the platelets level resolved spontaneously without intervention. Secondary outcomes: there were two VTE cases in the control group while no cases in the case study group (p: 0.68) CONCLUSION: Routine administration of Heparin to prevent VTE in post cesarean section patients had no significant increase in complications that would withhold providers from giving it routinely to this group of patients. Prospective studies are needed to prove the efficacy of pharmacological thromboprophylaxis in preventing VTE.