Pilot study on the use of low molecular weight heparins in the prevention of thromboembolic disease during pregnancy and puerperium

  1. Paloma Anchústegui-Mendizábal
  2. Patricia Anchústegui-Mendizábal
  3. Laura Arechabala-Palacios
  4. Laura Fernández-González
  5. Clara Garcia-Gil
  6. Jesús Miguel Hernández-Guijo
  7. Óscar Martínez-Pérez

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Abstract

A pregnant woman is 4 to 5 times more likely to suffer a thromboembolic event than a non-pregnant woman. Furthermore, an increase in these episodes has been observed in women infected with SARS-CoV-2 . Consequently, the prophylactic prescription of low-molecular-weight heparins (LMWH) in pregnant women is undergoing an increase that has not been evaluated yet. The aim of this study was to determine the prevalence of LMWH prescription in pregnant women at the Hospital Universitario Puerta de Hierro Majadahonda (HUPHM), according to their level of risk and its variation due to SARS-CoV-2 infection. To answer this question, a retrospective cohort of 113 women who gave birth during the month of February at the HUPHM was designed. The level of individual risk of thromboembolism, according to the Royal College guidelines (37a), was calculated with an interview to complete a questionnaire and the analysis of their clinical records. 53.6% of the women were prescribed LMWH as indicated in the guidelines. This high prevalence is explained by the high age of the pregnant women (over 35 years), the wave of the omicron variant (December 2021) and a high rate of cesarean sections (25%). On the other hand, the percentage of patients with COVID-19 was 17.6% but only 53% of them had received LMWH. In conclusion, LMWH is a very common prescription in obstetrics, mostly during puerperium, and has become even more relevant due to the COVID-19 pandemic

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    SciScore for 10.1101/2022.04.26.22274264: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: Inclusion and exclusion criteria: The inclusion criteria followed were: that the patients were over age, that they signed the informed consent form, that they had given birth, and that they were admitted to the gynecology and obstetrics department of the Hospital Universitario Puerta de Hierro Majadahonda (HUPHM).
    IRB: The trial was conducted in accordance with Good Clinical Practice guidelines and was sent for assessment by the Bioethics Committee of the HUPHM.
    Sex as a biological variableThe design was based on a literature search in Pubmed on the use of antithrombotics in pregnancy and the Royal College guidelines (37a) on thromboembolic risk in pregnant women were studied.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The design was based on a literature search in Pubmed on the use of antithrombotics in pregnancy and the Royal College guidelines (37a) on thromboembolic risk in pregnant women were studied.
    Pubmed
    suggested: (PubMed, RRID:SCR_004846)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2022.04.26.22274264v1 on medRxiv