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Postpartum wound and bleeding complications in women who received peripartum anticoagulation.

Publication ,  Journal Article
Limmer, JS; Grotegut, CA; Thames, E; Dotters-Katz, SK; Brancazio, LR; James, AH
Published in: Thromb Res
July 2013

INTRODUCTION: The objective of this study was to compare wound and bleeding complications between women who received anticoagulation after cesarean delivery due to history of prior venous thromboembolic disease, arterial disease, or being a thrombophilia carrier with adverse pregnancy outcome, to women not receiving anticoagulation. METHODS: Women in the Duke Thrombosis Center Registry who underwent cesarean delivery during 2003-2011 and received postpartum anticoagulation (anticoagulation group, n=77), were compared with a subset of women who delivered during the same time period, but did not receive anticoagulation (no anticoagulation group, n=77). The no anticoagulation group comprised women who were matched to the anticoagulation group by age, body mass index, type of cesarean (no labor vs. labor), and date of delivery. Bleeding and wound complications were compared between the two groups. A multivariable logistic regression model was constructed to determine if anticoagulation was an independent predictor of wound complication. RESULTS: Women who received anticoagulation during pregnancy had a greater incidence of wound complications compared to those who did not (30% vs. 8%, p<0.001). Using multivariable logistic regression, while controlling for race, diabetes, chorioamnionitis, and aspirin use, anticoagulation predicted the development of any wound complication (OR 5.8, 95% CI 2.2, 17.6), but there were no differences in the mean estimated blood loss at delivery (782 vs. 778 ml, p=0.91), change in postpartum hematocrit (5.4 vs. 5.2%, p=0.772), or percent of women receiving blood products (6.5 vs. 1.3%, p=0.209) between the two groups. CONCLUSIONS: Anticoagulation following cesarean delivery is associated with an increased risk of post-cesarean wound complications, but not other postpartum bleeding complications.

Duke Scholars

Published In

Thromb Res

DOI

EISSN

1879-2472

Publication Date

July 2013

Volume

132

Issue

1

Start / End Page

e19 / e23

Location

United States

Related Subject Headings

  • Wounds and Injuries
  • Retrospective Studies
  • Pregnancy Complications
  • Pregnancy
  • Postpartum Hemorrhage
  • Peripartum Period
  • Humans
  • Female
  • Cesarean Section
  • Cardiovascular System & Hematology
 

Citation

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Limmer, J. S., Grotegut, C. A., Thames, E., Dotters-Katz, S. K., Brancazio, L. R., & James, A. H. (2013). Postpartum wound and bleeding complications in women who received peripartum anticoagulation. Thromb Res, 132(1), e19–e23. https://doi.org/10.1016/j.thromres.2013.04.034
Limmer, Jane S., Chad A. Grotegut, Elizabeth Thames, Sarah K. Dotters-Katz, Leo R. Brancazio, and Andra H. James. “Postpartum wound and bleeding complications in women who received peripartum anticoagulation.Thromb Res 132, no. 1 (July 2013): e19–23. https://doi.org/10.1016/j.thromres.2013.04.034.
Limmer JS, Grotegut CA, Thames E, Dotters-Katz SK, Brancazio LR, James AH. Postpartum wound and bleeding complications in women who received peripartum anticoagulation. Thromb Res. 2013 Jul;132(1):e19–23.
Limmer, Jane S., et al. “Postpartum wound and bleeding complications in women who received peripartum anticoagulation.Thromb Res, vol. 132, no. 1, July 2013, pp. e19–23. Pubmed, doi:10.1016/j.thromres.2013.04.034.
Limmer JS, Grotegut CA, Thames E, Dotters-Katz SK, Brancazio LR, James AH. Postpartum wound and bleeding complications in women who received peripartum anticoagulation. Thromb Res. 2013 Jul;132(1):e19–e23.
Journal cover image

Published In

Thromb Res

DOI

EISSN

1879-2472

Publication Date

July 2013

Volume

132

Issue

1

Start / End Page

e19 / e23

Location

United States

Related Subject Headings

  • Wounds and Injuries
  • Retrospective Studies
  • Pregnancy Complications
  • Pregnancy
  • Postpartum Hemorrhage
  • Peripartum Period
  • Humans
  • Female
  • Cesarean Section
  • Cardiovascular System & Hematology