A Study on Risk Factors for Venous Thromboembolism and the Requirement of Thromboprophylaxis in Pregnancy and Postpartum Period in a Tertiary Care Centre in South Asian Country: A Cross Sectional Study

Introduction: Thrombosis is a major cause of maternal death worldwide. During pregnancy, the risk of venous thromboembolism (VTE) increases fourfold to five-fold and contributes towards maternal morbidity and mortality. Sri Lanka does not have a proper assessment tool to detect and manage it in the antenatal care. Objectives: To identify risks factors for VTE among pregnant mothers, postpartum mothers according to RCOG (Royal College of Obstetricians) risk categorization and to assess the requirement of thromboprophylaxis. Method: A cross sectional study was conducted at the antenatal clinics and obstetrics and gynaecology wards (ward 2, 5, 8) of De Soysa Hospital for Women in 2021. Obstetric thromboprophylaxis risk assessment tool recommended by the RCOG was used for the risk assessment of pregnant mothers during the antenatal and postpartum period. Results: In antenatal period, obesity (BMI > 35), age more than 35 years and parity more than 3 were the commonest risk factors. Out of 404 mothers, 67.33% did not have any risk factors. Among others, 18.56%, 0.40%, 2.72%, 0.99% had a score of 1, 2, 3 and 4 respectively. Patients with intermediate (0.99%) and high risk (2.72%) were commenced on thromboprophylaxis from 28 weeks. The low-risk category was not started on any treatment (28.96%, n = 97).