Affiliations: Department Obstetrics Gynecology, Women Hospital, GPR Hospital, 65428 Rüsselsheim, Germany | Department Obstetrics Gynecology, University Hospital, Aachen, Germany | Department Experimental Endocrinology, Mainz, Germany | Department Medicine, University of Texas, Dallas Thrombosis Hemostasis Clinical Center, 10455 North Central Expressway Suite 109, PMP 320, Dallas TX 75231, USA
Note: [] Corresponding author: Prof. Lothar Heilmann, Dept. Obstet. Gynec., Women Hospital, 65428 Rüsselsheim, Germany. E-mail: [email protected].
Abstract: Thromboembolic complications remain an important cause of maternal mortality. The present recommendations favour for prophylaxis unfractionated (UFH) and low molecular weight heparin (LMWH). We investigated 150 pregnant women before and after cesarean section in three randomized groups. Fifty women received no prophylaxis (group I), 50 women UFH two times 5000 IU/day (group III) and 50 women Dalteparin 5000 U/day (group II). We determined the blood count, the rheological parameters and cholesterol, triglycerides, D-dimer, fibrinogen and the anti-Xa-level. We found a classical hemodilution, with increase of erythrocyte aggregation and plasma viscosity postoperatively. The fibrinogen turnover and D-dimer concentration were elevated. The patients with Dalteparin prophylaxis showed lower thrombin activation, minor changes in the cholesterol and triglycerides level and an improvement of red cell deformability in low shear regions. Our results demonstrated an influence of Dalteparin on the rheological parameters post surgery. The DVT incidence was 1.33% generally and occurred only in the Control group and in women with unfractionated heparin. We observed no side effects such as major bleeding, osteopenia or allergy.
