1.Department of Obstetrics and Gynecology, Wuxi Rich Women and Children′s Hospital, Jiangsu Province, Wuxi 214002, China;
2.Department of Obstetrics and Gynecology, Yangzhou Maternal and Child Care Service Centre, Affilated Hospital of Yangzhou University, Jiangsu Province, Yangzhou 225002, China;
3.Information Section, Yangzhou Maternal and Child Care Service Centre, Affilated Hospital of Yangzhou University, Jiangsu Province, Yangzhou 225002, China
Abstract：Objective To investigate the incidence, risk factors, occurrence time, clinical manifestations and diagnosis of postpartum venous thrombosis, and to avoid overtreatment. Methods The clinical data of five cases of postpartum venous thrombosis in 47 948 pregnant women admitted to Yangzhou Maternal and Child Care Service Centre (hereinafter referred to as “our hospital”) from January 2012 to December 2018 were retrospectively analyzed. The score according to the criteria set out in the April 2015 Royal College of Obstetricians and Gynaecologists guidelines on reducing the risk of venous thromboembolism during pregnancy and puerperium, the differences in clotting function before delivery and at the time of thrombus discovery were compared. Meanwhile, the coagulation function was compared with that of 6525 normal pregnant women without complications and complications in the third trimester pregnancy in our hospital in 2018. Results All five cases were confirmed by color doppler ultrasonography or CT pulmonary angiography in general hospitals and our hospital, including three cases of deep vein thrombosis, two cases of superficial vein thrombosis, and one case of deep vein thrombosis. In recent six years, the incidence was (1.04-1.07)/10 000. All of the five cases occurred within one week after delivery. Among the five patients, one case had a risk factor score of four, one case had a risk factor score of three, and three cases had a risk factor score of one. Four cases had lower extremity pain symptoms. Comparison of coagulation function between the five patients before delivery and at the time of thrombosis discovery showed no statistically significant difference (P ＞ 0.05). However, compared with the coagulation function before delivery of 6525 normal pregnant women, the prothrombin time (PT) and thrombin time (TT) of five cases before delivery were shorter than that of normal pregnant women (P ＜ 0.05). There were no significant differences in activated partial prothrombin time, international standardized ratio, fibrinogen and D-dimer (P ＞ 0.05). After anticoagulant therapy, all the five cases recovered. Conclusion The incidence of postpartum venous thrombosis is low, PT and TT before delivery are shortened significantly and lower limb pain symptoms appear after delivery.
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2020, Vol. 17 
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