Title:Venous Thromboembolism Risk and Adequacy of Prophylaxis in High Risk Pregnancy in the Arabian Gulf
Volume: 14
Issue: 4
Author(s): Faisal Alsayegh, Waleed Al-Jassar, Salima Wani, Muna Tahlak, Awatef Albahar, Lamya Al Kharusi, Halima Al-Tamimi, Faten El-Taher, Naeema Mahmood and Ibrahim Al-Zakwani
Affiliation:
Keywords:
Venous thromboembolism, deep vein thrombosis, antiplatelet, anticoagulation, pregnancy, Middle East.
Abstract: Objectives: To estimate the prevalence of venous thromboembolism (VTE) risk factors in
pregnancy and the proportion of pregnancies at risk of VTE that received the recommended prophylaxis
according to the American College of Chest Physicians (ACCP) 2012 published guidelines in antenatal clinics in the
Arabian Gulf.
Methods: The evaluation of venous thromboembolism (EVE)-Risk project was a non-interventional, cross-sectional,
multi-centre, multi-national study of all eligible pregnant women (≥17 years) screened during antenatal clinics from 7 centres
in the Arabian Gulf countries (United Arab Emirates, Kuwait, Bahrain, Qatar and Oman). Pregnant women were recruited
during a 3-month period between September and December 2012.
Results: Of 4,131 screened pregnant women, 32% (n=1,337) had ≥1 risk factors for VTE. Common VTE risk factors included
obesity (76%), multiparity (33%), recurrent miscarriages (9.1%), varicose veins (6.9%), thrombophilia (2.6%),
immobilization (2.0%), sickle cell disease (2.8%) and previous VTE (1.6%). Only 8.3% (n=111) of the high risk patients
were on the recommended VTE prophylaxis. Enoxaparin was used in 80% (n=89) of the cases followed by tinzaparin
(4%; n=4). Antiplatelet agents were prescribed in 11% (n=149) of pregnant women. Of those on anticoagulants (n=111),
59% (n=66) were also co-prescribed antiplatelet agents. Side effects (mainly local bruising at the injection site) were reported
in 12% (n=13) of the cases.
Conclusion: A large proportion of pregnant women in the Arabian Gulf countries have ≥1 VTE risk factor with even a
smaller fraction on prophylaxis. VTE risk assessment must be adopted to identify those at risk who would need VTE prophylaxis.
