A comparison of the safety of two different enoxaparin doses for thromboprophylaxis following cesarean section

Abstract

Enoxaparin, from the low molecular weight heparin group, is used as thromboprophylaxis in patients with risk factors following caesarean section. The aim of this study was to investigate the effect of enoxaparin doses on the formation of deep vein thrombosis (DVT), wound site infection (WSI), wound site hematoma (WSH) and hemogram results of patients on the 10th postoperative day. A retrospective examination was made of the files of patients who had undergone a caesarean section operation and been administered enoxaparin as postpartum thromboprophylaxis for 10 days postoperatively. Two groups were formed of 16 patients who received enoxaparin at dose of 60mg/day and 25 patients who received 40mg/day. The groups were compared in respect of age, weight, gravida, gestational week at the time of operation, the leukocyte (Wbc), hemoglobin (Hb), and platelet (Plt) values on postoperative days 1 and 10, and the development of DVT, WSI, and WSH on postoperative day 10. The development of WSI and WSH was determined to be significantly higher in the group that received 60mg/day enoxaparin than in the group that received 40mg/day (p=0.007, p=0.008). With the use of 60mg/day enoxaparin, no change was observed in the Wbc and Hb values on the postoperative 10th day compared to the 1st day (p=0.128, p=0.947), and a significant reduction was determined in Plt values (p=0.014). With an increase in the dose of enoxaparin used as thromboprophylaxis following caesarean section in patients with risk factors, there was seen to be an increase in the formation of WSI and WSH. Compared to a dose of 40mg/day, the use of 60mg/day enoxaparin reduced serum Wbc, did not change Hb, and increased Plt values. Dose adjustment should be made for the drug used as caesarean postoperative thromboprophylaxis in patients with indications, taking the side-effects of enoxaparin into consideration.