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Thromboembolism Prophylaxis Urged for Caesarean Deliveries

Data suggests it could eliminate the excess risk of death associated with Caesarean deliveries

FRIDAY, Aug. 8 (HealthDay News) -- The maternal death rate in the United States could be systematically reduced if all women undergoing Caesarean delivery received thromboembolism prophylaxis, according to research published in the July issue of the American Journal of Obstetrics & Gynecology.

Steven L. Clark, M.D., of the Hospital Corporation of America in Nashville, Tenn., and colleagues reviewed 2000-2006 data on nearly 1.5 million pregnancies, including 95 that resulted in maternal death.

The researchers identified complications of preeclampsia, pulmonary thromboembolism, amniotic fluid embolism, obstetric hemorrhage and cardiac disease as the leading causes of maternal death, and concluded that only 28 percent of deaths were preventable because they resulted from errors committed by health care and non-health care personnel. They also found that the rate of maternal death causally related to the mode of delivery was higher for Caesarean than for vaginal delivery (2.2 versus 0.2 per 100,000 deliveries).

"With appropriate universal thromboembolism prophylaxis, our data suggest the excess risk of death because of Caesarean delivery may be virtually eliminated, and the overall risk of death attributable to this operation would be less than one per 100,000," the authors conclude. "Given the potential for bleeding complications with methods of neuraxial anesthesia commonly used for Caesarean delivery, we are in the process of implementing a policy of universal pneumatic compression device use for all women undergoing Caesarean delivery in our system."

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