Kobayashi T.
[Obstetrics and gynecology]
Nippon Rinsho. 2003 Oct;61(10):1787-92. Review. Japanese.

Shinshu University School of Health Sciences.
Pregnancy has been recognized as a predisposing risk factor of deep
venous thrombosis(DVT) and pulmonary
thromboembolism(PTE). Recently, we investigated the incidence of
PTE between 1991 and 2000 among 64 facilities of Obstetrics
and Gynecology in Japan. As a result, incidences of PTE are
0.006% (14/227,318) in cases of vaginal delivery and
0.046%(25/54,277) in cases of cesarean section (CS) in
Obstetrics. In Gynecology, they are 0.03% (34/106,598) in
patients of benign tumors and 0.33%(54/16,206) in patients of
malignant tumors. Classification of level of risks in Japanese
subjects at present is thought to be as follows; cases of normal
delivery and minor surgery are low risk, cases of CS and benign
gynecological tumors are moderate risk, cases of CS with elderly
fatty pregnant women and gynecological malignant tumors are
high risk, and cases of CS or malignant tumors with
thrombophilia or pre-DVT are the highest risk. Prophylaxis of
DVT should be recommended early ambulation and adequate
hydration in low risk cases, graduated compression stocking
(GCS) or intermittent pneumatic compression (IPC) in moderate risk
cases, IPC or the use of low-dose unfractionated heparin(LDUH)
(and/or GCS) in high risk cases, and LDUH and IPC or LDUH
and GCS in the highest risk cases.