Farrukh Naheed, Karim Kammeruddin, Amber Tufail, Peter Baillie, Ali Hussain.
Evaluation of risk factors for venous Thrombo-embolism and Thrombo-prophylaxis with unfractionated heparin in post operative gynaecological patients.
J Surg Pak Jan ;13(3):95-8.

Objective: To evaluate the risk factors responsible for venous thrombo-embolism (VTE) in post operative gynaecological patients and to observe the effect of thrombo-prophylaxis with unfractionated heparin in reducing postoperative morbidity and mortality. Study Design: Case control study. Place and duration of study: The study was conducted in Obstetrics & Gynaecological Department at Fatima Hospital, Baqai Medical University Karachi, from March 2006 to February 2008. Patients and Methods: One hundred and fifty post operative gynaecological patients were selected randomly, consecutively and alternatively. Risk factors i.e age ≥ 45 years, high parity- more than 5, associated medical disorders (diabetes mellitus, hypertension and obesity- BMI >30 kg/m2), prolong surgery, immobilization as well as past history of VTE, were recorded. All patients were divided into 2 groups. Group A included 75 patients who received thrombo-embolic prophylaxis with unfractionated heparin (5000 I.U.) subcutaneously, 8 or 12 hourly till they were discharged from the hospital, whereas equal number of patients taken in group B who did out receive any kind of thrombo-embolic prophylaxis. Detail history, examination and investigations were done after consultation with medical department with regard to co-morbidities. Results: Eight risk factors were evaluated in all post operative gynaecological patients. Among them age of patients ≥ 45 years was considered to be significant in terms of post operative VTE events (p value= 0.058). Over all effect of thrombo-prophylaxis via subcutaneously unfractionated heparin (5000 I.U.) was found to be beneficial in reducing post operative morbidity. Conclusions: Early recognition of possible risk factors especially females with age age ≥ 45 yeas is important for the prevention of post operative morbidity and mortality. Thrombo-prophylaxis by unfractionated heparin for most of the gynaecological patients was found to be beneficial and cost effective.

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