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Prophylaxis for venous thromboembolic disease in pregnancy and the early postnatal period

  1. Emily Bain1,*,
  2. Agnes Wilson2,
  3. Rebecca Tooher3,
  4. Simon Gates4,
  5. Lucy-Jane Davis5,
  6. Philippa Middleton1

Editorial Group: Cochrane Pregnancy and Childbirth Group

Published Online: 11 FEB 2014

Assessed as up-to-date: 27 NOV 2013

DOI: 10.1002/14651858.CD001689.pub3


How to Cite

Bain E, Wilson A, Tooher R, Gates S, Davis LJ, Middleton P. Prophylaxis for venous thromboembolic disease in pregnancy and the early postnatal period. Cochrane Database of Systematic Reviews 2014, Issue 2. Art. No.: CD001689. DOI: 10.1002/14651858.CD001689.pub3.

Author Information

  1. 1

    The University of Adelaide, ARCH: Australian Research Centre for Health of Women and Babies, The Robinson Institute, Discipline of Obstetrics and Gynaecology, Adelaide, South Australia, Australia

  2. 2

    The Royal Australian and New Zealand College of Obstetricians and Gynaecologists, Melbourne, Australia

  3. 3

    The University of Adelaide, Discipline of Public Health, School of Population Health, Adelaide, South Australia, Australia

  4. 4

    Division of Health Sciences, Warwick Medical School, The University of Warwick, Warwick Clinical Trials Unit, Coventry, UK

  5. 5

    University of Bristol, Department of Social Medicine, Bristol, UK

*Emily Bain, ARCH: Australian Research Centre for Health of Women and Babies, The Robinson Institute, Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, South Australia, 5006, Australia. emily.bain@adelaide.edu.au.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 11 FEB 2014

SEARCH

[Figure 1]
Figure 1. 'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
[Figure 2]
Figure 2. 'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
[Analysis 1.1]
Analysis 1.1. Comparison 1 Antenatal prophylaxis: LMWH or UFH versus no treatment or placebo, Outcome 1 Symptomatic thromboembolic events.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Antenatal prophylaxis: LMWH or UFH versus no treatment or placebo, Outcome 2 Symptomatic pulmonary embolism.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Antenatal prophylaxis: LMWH or UFH versus no treatment or placebo, Outcome 3 Symptomatic deep vein thrombosis.
[Analysis 1.4]
Analysis 1.4. Comparison 1 Antenatal prophylaxis: LMWH or UFH versus no treatment or placebo, Outcome 4 Blood transfusion.
[Analysis 1.5]
Analysis 1.5. Comparison 1 Antenatal prophylaxis: LMWH or UFH versus no treatment or placebo, Outcome 5 Bleeding episodes (antenatal vaginal bleeding).
[Analysis 1.6]
Analysis 1.6. Comparison 1 Antenatal prophylaxis: LMWH or UFH versus no treatment or placebo, Outcome 6 Serious wound complications.
[Analysis 1.7]
Analysis 1.7. Comparison 1 Antenatal prophylaxis: LMWH or UFH versus no treatment or placebo, Outcome 7 Symptomatic osteoporosis.
[Analysis 1.8]
Analysis 1.8. Comparison 1 Antenatal prophylaxis: LMWH or UFH versus no treatment or placebo, Outcome 8 Fetal loss.
[Analysis 1.9]
Analysis 1.9. Comparison 1 Antenatal prophylaxis: LMWH or UFH versus no treatment or placebo, Outcome 9 Thrombocytopenia.
[Analysis 2.1]
Analysis 2.1. Comparison 2 Antenatal prophylaxis: LMWH versus UFH, Outcome 1 Symptomatic thromboembolic events.
[Analysis 2.2]
Analysis 2.2. Comparison 2 Antenatal prophylaxis: LMWH versus UFH, Outcome 2 Symptomatic pulmonary embolism.
[Analysis 2.3]
Analysis 2.3. Comparison 2 Antenatal prophylaxis: LMWH versus UFH, Outcome 3 Symptomatic deep vein thrombosis.
[Analysis 2.4]
Analysis 2.4. Comparison 2 Antenatal prophylaxis: LMWH versus UFH, Outcome 4 Blood transfusion.
[Analysis 2.5]
Analysis 2.5. Comparison 2 Antenatal prophylaxis: LMWH versus UFH, Outcome 5 Bleeding episodes (variously defined).
[Analysis 2.6]
Analysis 2.6. Comparison 2 Antenatal prophylaxis: LMWH versus UFH, Outcome 6 Adverse effects sufficient to stop treatment.
[Analysis 2.7]
Analysis 2.7. Comparison 2 Antenatal prophylaxis: LMWH versus UFH, Outcome 7 Adverse effects not sufficient to stop treatment (injection burning).
[Analysis 2.8]
Analysis 2.8. Comparison 2 Antenatal prophylaxis: LMWH versus UFH, Outcome 8 Symptomatic osteoporosis.
[Analysis 2.9]
Analysis 2.9. Comparison 2 Antenatal prophylaxis: LMWH versus UFH, Outcome 9 Fetal loss.
[Analysis 2.10]
Analysis 2.10. Comparison 2 Antenatal prophylaxis: LMWH versus UFH, Outcome 10 Thrombocytopenia.
[Analysis 3.1]
Analysis 3.1. Comparison 3 Caesarean section: LMWH or UFH versus no treatment or placebo, Outcome 1 Symptomatic thromboembolic events.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Caesarean section: LMWH or UFH versus no treatment or placebo, Outcome 2 Symptomatic pulmonary embolism.
[Analysis 3.3]
Analysis 3.3. Comparison 3 Caesarean section: LMWH or UFH versus no treatment or placebo, Outcome 3 Symptomatic deep vein thrombosis.
[Analysis 3.4]
Analysis 3.4. Comparison 3 Caesarean section: LMWH or UFH versus no treatment or placebo, Outcome 4 Blood transfusion.
[Analysis 3.5]
Analysis 3.5. Comparison 3 Caesarean section: LMWH or UFH versus no treatment or placebo, Outcome 5 Bleeding episodes (variously defined).
[Analysis 3.6]
Analysis 3.6. Comparison 3 Caesarean section: LMWH or UFH versus no treatment or placebo, Outcome 6 Serious wound complications.
[Analysis 3.7]
Analysis 3.7. Comparison 3 Caesarean section: LMWH or UFH versus no treatment or placebo, Outcome 7 Adverse effects sufficient to stop treatment.
[Analysis 3.8]
Analysis 3.8. Comparison 3 Caesarean section: LMWH or UFH versus no treatment or placebo, Outcome 8 Adverse effects not sufficient to stop treatment.
[Analysis 4.1]
Analysis 4.1. Comparison 4 Caesarean section: LMWH versus UFH, Outcome 1 Symptomatic thromboembolic events.
[Analysis 4.2]
Analysis 4.2. Comparison 4 Caesarean section: LMWH versus UFH, Outcome 2 Symptomatic pulmonary embolism.
[Analysis 4.3]
Analysis 4.3. Comparison 4 Caesarean section: LMWH versus UFH, Outcome 3 Symptomatic deep vein thrombosis.
[Analysis 4.4]
Analysis 4.4. Comparison 4 Caesarean section: LMWH versus UFH, Outcome 4 Bleeding episodes ("haemorrhagic events").
[Analysis 5.1]
Analysis 5.1. Comparison 5 Caesarean section: HES versus UFH, Outcome 1 Asymptomatic thromboembolic events.
[Analysis 5.2]
Analysis 5.2. Comparison 5 Caesarean section: HES versus UFH, Outcome 2 Blood transfusion.
[Analysis 5.3]
Analysis 5.3. Comparison 5 Caesarean section: HES versus UFH, Outcome 3 Bleeding episodes.
[Analysis 5.4]
Analysis 5.4. Comparison 5 Caesarean section: HES versus UFH, Outcome 4 Serious wound complications.
[Analysis 6.1]
Analysis 6.1. Comparison 6 Caesarean section: five-day LMWH versus 10-day LMWH, Outcome 1 Maternal death.
[Analysis 6.2]
Analysis 6.2. Comparison 6 Caesarean section: five-day LMWH versus 10-day LMWH, Outcome 2 Symptomatic thromboembolic events.
[Analysis 6.3]
Analysis 6.3. Comparison 6 Caesarean section: five-day LMWH versus 10-day LMWH, Outcome 3 Symptomatic pulmonary embolism.
[Analysis 6.4]
Analysis 6.4. Comparison 6 Caesarean section: five-day LMWH versus 10-day LMWH, Outcome 4 Symptomatic deep vein thrombosis.
[Analysis 6.5]
Analysis 6.5. Comparison 6 Caesarean section: five-day LMWH versus 10-day LMWH, Outcome 5 Post-caesarean infection.
[Analysis 7.1]
Analysis 7.1. Comparison 7 Postnatal (including after vaginal deliveries): UFH versus no treatment, Outcome 1 Symptomatic thromboembolic events.
[Analysis 7.2]
Analysis 7.2. Comparison 7 Postnatal (including after vaginal deliveries): UFH versus no treatment, Outcome 2 Symptomatic pulmonary embolism.
[Analysis 7.3]
Analysis 7.3. Comparison 7 Postnatal (including after vaginal deliveries): UFH versus no treatment, Outcome 3 Symptomatic deep vein thrombosis.