Poster Session

P160. Questioning the need for thromboprophylaxis in dvt among indian women in coastal region

Adithi Shetty (IN), Priya Ballal (IN)

[Shetty] KMC Mangalore , [Ballal] KMC Mangalore

CONTEXT: Deep Vein Thrombosis(DVT) prophylaxis in obstetrics is practiced differently worldwide. This could be attributed to interaction of various environmental, regional and genetic factors in a dynamic pattern. Studies show a geographic variance with least incidence among Asians. Various governing bodies have suggested guidelines for good practice but there seems to be no uniformity in risk stratification. Use of unfractionated/LMW heparin for prophylaxis is not without complications as literature reports-heparin induced thrombocytopenia, major bleeding. OBJECTIVES: To evaluate incidence of DVT among patients presenting with known high risk factors. METHODS: An observational retrospective study conducted over a 1 year period-June 2016-June 2017 at a tertiary referral teaching hospital in South India. 6331 patients who delivered at the centre were stratified based on presentation of risk factors. The risk factors considered were those mentioned in RCOG & ACOG guidelines. Number of patients who received thromboprophylaxis was also noted. Medical records of patients included in the study were analyzed for demographic variables and outcomes. OUTCOME MEASURES: Number of patients among the 6331 deliveries who presented with high risk factors for DVT were identified and the incidence of DVT among them was noted. RESULTS: None of the patients in the study group developed DVT.44% were delivered by Caesarean(CS), of which majority were Emergency indications.45% of the study population were identified to have established risk factors.30% were low and 69.3% were intermediate and only 1 belonged to the high risk category. Preeclampsia seemed to be the second most independent risk factor after Emergency CS. On studying demographic variable, majority of the group were <35yrs of age (2% in > 35yrs). Multiparity of > =3 comprised only 4% ,while BMI > 30mg/m2 was seen in only 0.5% of patients in the study population. CONCLUSIONS: Incidence of DVT as reported by this study is negligible. Development of DVT in the presence of intermediate risk factors was also negligible, questioning the need for thromboprophylaxis. Young age group, normal BMI, diet rich in coconut oil, seafood and vegetables could be attributed. Need for individualizing guidelines to Indian standards is evident.