Prevalence of Deep Vein Thrombosis and Associated Risk Factors During Pregnancy and Puerperium in Omdurman Maternity Hospital from March 2021-August 2021


Authors : Ali Mohamed Ali Elimam; Ayat Salih Abas Ahmed; Sakeena NourEldine Salih

Volume/Issue : Volume 10 - 2025, Issue 3 - March

Google Scholar : https://tinyurl.com/2a8xkcfd

Scribd : https://tinyurl.com/339pr2t8

DOI : https://doi.org/10.38124/ijisrt/25mar047

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Abstract : Introduction: Women during pregnancy and postpartum period represent one of the highest risk groups for DVT. The treatment and supportive measures are of paramount importance to reduce the risk and complications of this disease. Moreover complications which can occur to the fetus and maternal health during pregnancy should be taken into account in treatment.  Methodology: This study is a cross sectional hospital-based study. It was conducted during the period March 2021-August2021, in Omdurman maternity hospital, included women during pregnancy or puerperium. Patient interviewed through a detailed questionnaire and some information obtained from patients file. For event of deep vein thrombosis, associated factors and feto-maternal outcome. Data was processed using the SPSS (vs. 26).  Results: Among 13828 deliveries, 50 patients had deep vein thrombosis the prevalence was 0.36%. The mean patient’s age was 31.74±6.5 years (range was 18-45 years). The majority of DVT 34 (68%) occur during puerperium, and 16(32%) occur during pregnancy, 8(16%) had history of similar condition, and 20(40%) had family history of similar condition. Chronic illnesses mostly hypertension 9(56.3%), and anemia was in 19(38%). The mode of delivery was vaginal delivery in 26(52%). The mean duration of hospital stay was 6.7±6.0 (range from 1- 30 days). DVT was managed in majority using heparin 33(66 %), LMWH + warfarin in 9(18%), of patients pulmonary embolism was in 3(6%), and the death rate was 1(2%). 5(10%) of fetuses admitted to NICU.  Conclusion: Deep vein thrombosis prevalence was 0.36% and it is more frequent during puerperium.

Keywords : Prevalence, Deep Vein Thrombosis, Risk Factors, Pregnancy, Puerperium.

References :

  1. Creanga AA, Syverson C, Seed K, Callaghan WM. Pregnancy-related mortality in the United States, 2011e2013. Obstet Gynecol 2017; 130:366e73.
  2. Heit JA, Kobbervig CE, James AH, Petterson TM, Bailey KR, Melton LJ. Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study. Ann Intern Med 2005; 143:697e706
  3. Greer IA. Thrombosis in pregnancy: maternal and fetal issues. Lancet 1999; 353:1258e65.
  4. Wik H, Jacobsen A, Sandvik L, Sandset P. Prevalence and predictors for postthrombotic syndrome 3 to 16 years after pregnancy-related venous thrombosis: a population-based, cross-sectional, case-control study. J Thromb Haemostasis 2012; 10:840.
  5. Duhl AJ, Paidas MJ, Ural SH, Branch W, Casele H, Cox-Gill J, et al. Antithrombotic therapy and pregnancy: consensus report and recommendations for prevention and treatment of venous thromboembolism and adverse pregnancy outcomes. Am J Obstet Gynecol 2007; 197:457. e1-. e21.
  6. Jacobsen AF, Skjeldestad FE, Sandset PM. Incidence and risk patterns of venous thromboembolism in pregnancy and puerperiumda register-based casecontrol study. Am J Obstet Gynecol 2008; 198:233.e1-. e7.
  7. James AH, Jamison MG, Brancazio LR, Myers ER. Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality. Am J Obstet Gynecol 2006; 194:1311e5.
  8. Jang MJ, Bang SM, Oh D. Incidence of pregnancy-associated venous thromboembolism in Korea: from the health insurance review and assessment service database. J Thromb Haemostasis 2011; 9:2519e21
  9. Liu S, Rouleau J, Joseph K, Sauve R, Liston RM, Young D, et al. Epidemiology of pregnancy-associated venous thromboembolism: a population-based study in Canada. J Obstet Gynaecol Can 2009; 31:611e20.
  10. Previtali E, Bucciarelli P, Passamonti SM, Martinelli I. Risk factors for venous and arterial thrombosis. Blood Transfus 2011; 9:120.
  11. James A, Bushnell C, Jamison M, Myers E. Incidence and risk factors for stroke in pregnancy and the puerperium. Obstet Gynecol 2005; 106:509e16.
  12. Bates SM, Middeldorp S, Rodger M, James AH, Greer I. Guidance for the treatment and prevention of obstetric-associated venous thromboembolism. J Thromb Thrombolysis 2016; 41:92e128.
  13. Gynaecologists R. egnancy and the puerperium. In: Green-top Guideline, 37; 2015. p. 1e40.
  14. Handady S. O., Abdelwahid A, Abd Alla S. , Ahmed H. S., Mandar O. M. Rate and Risk Profile of Deep Venous Thrombosis in Pregnancy and Postpartum Period Among Sudanese Women. W J Gynecol Women’s Health. 2(5): 2019 WJGWH.MS.ID.000546
  15. Galambosi PJ, Gissler M, Kaaja RJ, Ulander VM. Incidence and risk factors of venous thromboembolism during postpartum period: a population‐based cohort‐study. Acta Obstetricia et Gynecologica Scandinavica. 2017 Jul; 96(7):852-61.
  16. Park JE, Park Y, Yuk JS. Incidence of and risk factors for thromboembolism during pregnancy and postpartum: a 10-year nationwide population-based study. Taiwanese Journal of Obstetrics and Gynecology. 2021 Jan 1; 60(1):103-10.
  17. Jacobsen AF, Skjeldestad FE, Sandset PM. Ante‐and postnatal risk factors of venous thrombosis: a hospital‐based case–control study. Journal of thrombosis and haemostasis. 2008 Jun;6(6):905-12.
  18. Jang MJ, Bang SM, Oh D. Incidence of pregnancy‐associated venous thromboembolism in Korea: from the Health Insurance Review and Assessment Service database. Journal of Thrombosis and Haemostasis. 2011 Dec 1; 9(12):2519.
  19. Liu S, Rouleau J, Joseph KS, Sauve R, Liston RM, Young D, Kramer MS. Epidemiology of pregnancy-associated venous thromboembolism: a population-based study in Canada. Journal of Obstetrics and Gynaecology Canada. 2009 Jul 1; 31(7):611-20.
  20. Huang D, Wong E, Zuo ML, Chan PH, Yue WS, Hu HX, Chen L, Yin LX, Cui XW, Wu MX, Su X. Risk of venous thromboembolism in Chinese pregnant women: Hong Kong venous thromboembolism study. Blood research. 2019 Sep 30; 54(3):175-80.
  21. QIN C, Tang S, CHEN J, LU J, XIE J, SUN M. Risk Factors for Venous Thromboembolism in Pregnancy and Postpartum: A Systematic Review and Meta-analysis.2022. March 30
  22. Okoroh EM, Azonobi IC, Grosse SD, Grant AM, Atrash HK, James AH. Prevention of venous thromboembolism in pregnancy: a review of guidelines, 2000-2011. J Womens Health (Larchmt) 2012; 21:611–615.
  23. Gader AA, Haggaz AE, Adam I. Epidemiology of deep venous thrombosis during pregnancy and puerperium in Sudanese women. Vascular health and risk management. 2009; 5:85.
  24. Simpson EL, Lawrenson RA, Nightingale AL, Farmer RD. Venous thromboembolism in pregnancy and the puerperium: incidence and additional risk factors from a London perinatal database. BJOG. 2001; 108:56–60. 
  25. Ohira T, Cushman M, Tsai MY, Zhang Y, Heckbert SR, Zakai NA, Rosamond WD, Folsom AR. ABO blood group, other risk factors and incidence of venous thromboembolism: the Longitudinal Investigation of Thromboembolism Etiology (LITE). Journal of thrombosis and haemostasis. 2007 Jul; 5(7):1455-61.
  26. Larsen TB, Sorensen HT, Gislum M, Johnsen SP (2007) Maternal smoking, obesity, and risk of venous thromboembolism during pregnancy and the puerperium: A population-based nested case-control study. Thromb Res 120: 505–509.
  27. Sultan AA, Tata LJ, West J, Fiaschi L, Fleming KM, Nelson-Piercy C, Grainge MJ. Risk factors for first venous thromboembolism around pregnancy: a population-based cohort study from the United Kingdom. Blood, the Journal of the American Society of Hematology. 2013 May 9; 121(19):3953-61.
  28. Virkus RA, Løkkegaard E, Lidegaard Ø, Langhoff-Roos J, Nielsen AK, Rothman KJ, Bergholt T. Risk factors for venous thromboembolism in 1.3 million pregnancies: a nationwide prospective cohort. PloS one. 2014 May 2;9(5):e96495.
  29. Henriksson P, Westerlund E, Wallen H, Brandt L, Hovatta O, et al. (2013) Incidence of pulmonary and venous thromboembolism in pregnancies after in vitro fertilisation: Cross sectional study. BMJ 346: e8632.
  30. Pabinger I, Grafenhofer H, Kyrle PA, et al. Temporary increase in the risk for recurrence during pregnancy in women with a history of venous thromboembolism. Blood. 2002; 100:1060–1062.
  31. Pabinger I, Grafenhofer H, Kaider A, et al. Risk of pregnancy-associated recurrent venous thromboembolism in women with a history of venous thrombosis. J Thromb Haemost. 2005; 3:949–954.
  32. De Stefano V, Martinelli I, Rossi E, et al. The risk of recurrent venous thromboembolism in pregnancy and puerperium without antithrombotic prophylaxis. Br J Haematol. 2006; 135:386–391.
  33. Lepercq J, Conard J, Borel-Derlon A, et al. Venous thromboembolism during pregnancy: a retrospective study of enoxaparin safety in 624 pregnancies. BJOG. 2001; 108:1134–1140.
  34. Jain P, Vishnu M, Lende V, Davra D, Sravan CP, Narkhede P, Giirija KR, Suresh KR. Analysis of risk factors and complications in postpartum lower extremity deep vein thrombosis patients at a single center. Indian Journal of Vascular and Endovascular Surgery. 2018 Jan 1; 5(1):22.
  35. Richter C, Sitzmann J, Lang P, Weitzel H, Huch A, Huch R, et al. Excretion of low molecular weight heparin in human milk. Br J Clin Pharmacol 2001;52:708-10.
  36. Royal College of Obstetricians & Gynaecologists. Reducing the risk of venous thromboembolism during pregnancy and the puerperium. Green Top Guideline. 2015 Apr (37a).
  37. Kahn SR, Shapiro S, Wells PS, Rodger MA, Kovacs MJ, Anderson DR, et al. Compression stockings to prevent post-thrombotic syndrome: A randomised placebo-controlled trial. Lancet 2014; 383:880-8. 
  38. BIrON-aNDrÉaNI, christine. Phlebolymphology 2013; 20:167-73.
  39. Blondon, M, Quon, BS, Harrington, LB, Bounameaux, H, Smith, NL. Association between newborn birth weight and the risk of postpartum maternal venous thromboembolism clinical perspective: a population-based case–control study. Circulation. 2015; 131(17):1471–1476.
  40. Zhou ZH, Chen Y, Zhao BH, Jiang Y, Luo Q. Early postpartum venous thromboembolism: risk factors and predictive index. Clinical and Applied Thrombosis/Hemostasis. 2019 Mar 7; 25:1076029618818777.
  41. Adams, T, Yeh, C, Bennett-Kunzier, N, Kinzler, WL. Long-term maternal morbidity and mortality associated with ischemic placental disease. Semin Perinatol. 2014; 38(3):146–150.

Introduction: Women during pregnancy and postpartum period represent one of the highest risk groups for DVT. The treatment and supportive measures are of paramount importance to reduce the risk and complications of this disease. Moreover complications which can occur to the fetus and maternal health during pregnancy should be taken into account in treatment.  Methodology: This study is a cross sectional hospital-based study. It was conducted during the period March 2021-August2021, in Omdurman maternity hospital, included women during pregnancy or puerperium. Patient interviewed through a detailed questionnaire and some information obtained from patients file. For event of deep vein thrombosis, associated factors and feto-maternal outcome. Data was processed using the SPSS (vs. 26).  Results: Among 13828 deliveries, 50 patients had deep vein thrombosis the prevalence was 0.36%. The mean patient’s age was 31.74±6.5 years (range was 18-45 years). The majority of DVT 34 (68%) occur during puerperium, and 16(32%) occur during pregnancy, 8(16%) had history of similar condition, and 20(40%) had family history of similar condition. Chronic illnesses mostly hypertension 9(56.3%), and anemia was in 19(38%). The mode of delivery was vaginal delivery in 26(52%). The mean duration of hospital stay was 6.7±6.0 (range from 1- 30 days). DVT was managed in majority using heparin 33(66 %), LMWH + warfarin in 9(18%), of patients pulmonary embolism was in 3(6%), and the death rate was 1(2%). 5(10%) of fetuses admitted to NICU.  Conclusion: Deep vein thrombosis prevalence was 0.36% and it is more frequent during puerperium.

Keywords : Prevalence, Deep Vein Thrombosis, Risk Factors, Pregnancy, Puerperium.

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