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Review Links C-Section With Increased Risk of Postpartum VTE

Meta-analysis shows increased risk is greater after emergency cesarean than after elective cesarean

WEDNESDAY, Sept. 28, 2016 (HealthDay News) — Cesarean section (CS) is associated with increased risk of postpartum venous thromboembolism (VTE), and the risk is greater following emergency CS versus elective, according to a meta-analysis published in the September issue of CHEST.

Marc Blondon, M.D., from Geneva University Hospitals, and colleagues conducted a systematic review of the correlation between CS and postpartum VTE. Data were included from 28 mainly retrospective observational studies, which compared the risk of VTE following vaginal deliveries (with more than 53,000 VTE events), and 32 prospective studies reporting VTE risks following CS (218 VTE events).

The researchers found that the relative risk of VTE following CS ranged from 1 to 22 compared with vaginal deliveries, with a meta-analytic odds ratio of 3.7. The estimated pooled odds ratio was marginally influenced by adjustment for age and body mass index. There were associations seen for elective and emergency CS, with stronger estimates for emergency CS. The pooled incidence was 2.6 VTE per 1,000 CS. Greater incidence was seen in studies with a longer and better follow-up in the postpartum period (4.3 per 1,000 CS).

“The risk of VTE was four-fold greater following CS than following vaginal deliveries, seemed independent of other VTE risk factors, and was greater following emergency CS than following elective CS,” the authors write.

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