Deep vein thrombosis in female patients admitted to the Teaching Hospitals in Aden

الملخص EN

From our clinical observations we found that the incidence of Lower Limb DVT is frequent in our female patients.

This study is having the aim to through light this problem and to clarify the incidence and the role of precipitating factors.

128 cases admitted to the teaching hospitals of Aden ( Al-Gamhouria & Al-Wahda Teaching Hospitals) in the period between August 2003 and July 2006, were studied.

The incidence is twice higher than in other populations (40cases±2/year in two hospitals Vs 8 cases/year in Malaysia*).

70% of the cases were related to the peripartum period.

Smoking with Khat chewing was noted in 60% of cases.

90% adhered to social habits.

They were confined to bed rest for 40 days after delivery with little or insufficient fluid intake.

Real time Ultrasound (US) with Duplex-Doppler was the only technique to verify the diagnosis.

46% of these cases were admitted during the early days of puerperium, 24% were admitted during pregnancy mainly the 3rd trimester, and 12% were related to the consequences of surgical operations, either pelvic including caesarian section, or general surgery.

18% had other systemic illnesses including debilitating diseases.

Lower Limb DVT (LLDVT), were found to be as follows: 80% Left LL DVT, 7% bilateral LLDVT (3 cases of 9 proved thrombus extending bilaterally).

13% right LLDVT (2 cases of 17 were having thrombus) p=0.03.

10 patients (8% of cases) died due to being in the end stage CHF, Cor Pulmonale, respiratory failure and 2 cases of them died due to massive Pulmonary Embolism.

Warfarin was the drug at discharge.

Doses were varied from 3-7.5mg according to the results of INR (international normalized ratio) with Heparin substitution for the cases during 1st and 3rd trimester.

Advocating early mobilization of post-delivery females, with advice for more fluid intake the possibility of high frequency of genetic hypercoagulable states and alteration of fibrinolytic factors behind this high incidence among Yemeni ladies should be clarified by research directed to this problem.

Encouraging pregnant patients in the early peurperium for early mobilization and to have more fluid intake have been proven to improve venous circulation