On Aug. 22 2011, the American College of Obstetricians and Gynecologists (The College) announced new recommendations to prevent blood clots during Cesarean Deliveries.
The new guidelines will be published in Sept. 2011 issue of the Green Journal. Blood clots, medically known as venous thromboembolic events (VTEs), are a leading cause of maternal mortality in USA and Canada. The College now recommends that all women having a cesarean delivery receive preventive intervention at the time of delivery. The most cost effective method would be sequential compressive devices (SCDs) to be placed on the lower extremities of a patient before a Cesarean and removed after surgery only when adequate ambulation is attained.
The risk of developing blood clots is increased four folds during pregnancy and two folds during and after a Cesarean delivery. Blood clots can block blood flow and cause damage to certain organs. The most common site of a blood clot in a pregnant patient is the left lower leg but other sites are commonly affected. Symptoms include swelling and pain in affected limb. If a clot gets dislodged, it can travel to the lungs causing a life-threatening condition known as pulmonary embolism (PE). Symptoms include sudden shortness of breath, chest pain, and coughing.
The recommendations explain how to monitor women for these events, address certain risk factors, and treat suspected or acute cases of VTE. “It’s important for ob-gyns to adopt these recommendations to help reduce maternal deaths.” said Dr. Andra H. James who helped develop the guidelines.
The Society of Obstetricians and Gynecologists of Canada (SOGC) has no clear recommendations on using VTE prevention during a Cesarean delivery for patients who are at low risk. Regardless of the plethora of new research on this topic, the SOGC guidelines were last updated in 2000. (See Prevention and Treatment of Venous Thromboembolism (VTE) in Obstetrics).
If you or someone you know are undergoing a Cesarean delivery ask the doctor about methods of VTE prevention she/he are implementing.