LMW heparin or compression both prevent thromboembolism after gynecologic surgery

NEW YORK (Reuters Health) – Among women undergoing surgery for gynecological malignancy, both low molecular weight heparin and external pneumatic compression are effective in prophylaxis of thromboembolism.

Dr. Daniel L. Clarke-Pearson and colleagues from Duke University Medical Center, Durham, North Carolina, randomly assigned 211 women, over 40 years of age, undergoing major surgery for gynecological malignancy, to either strategy.

Two patients receiving low molecular weight heparin developed venous thrombosis, as did one patient receiving external pneumatic compression, according to a report in the December issue of Obstetrics and Gynecology.

When Dr. Clarke-Pearson's team looked at the frequency of bleeding complications they found that the number of perioperative transfusions and estimated intraoperative blood loss was similar in both patient groups.

"Both external pneumatic compression and low molecular weight heparin are acceptable methods of thromboembolism prophylaxis in patients undergoing major abdominal surgery for gynecologic malignancy," Dr. Clarke-Pearson and colleagues conclude.

"Unlike unfractionated heparin, an increased frequency of bleeding complications is not associated with the prophylactic schedule of low molecular weight heparin used in this trial," they point out.

Obstet Gynecol 2001;98:989-995

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