Reduction in fatal pulmonary embolism and venous thrombosis by perioperative administration of low molecular weight heparin. Gynecological ward retrospective analysis.

Objective: To compare the frequency of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing gynecological operations without low molecular weight heparin (LMWH) prophylaxis and those receiving such prophylaxis.

Methods: Retrospective, hospital record-based study. Methods: About 1785 consecutive patients without LMWH prophylaxis and 1871 ones treated with nadroparin (Fraxiparine) 7500ICU s.c. 2h before the operation and repeated daily for 5-7 days or until the patient was fully mobile. DVT was diagnosed on the basis of clinical symptoms and ultrasound examination, and PE on clinical symptoms, gasometric data, electrocardiography and chest X-ray.

Results: Among the patients without prophylaxis, four cases of PE occurred (0.22%), two fatal (0.11%), 13 cases of proximal DVT (0.72%) and 41 distal DVT complications (2.3%). In LMWH, group 3 proximal DVT (0.16%) and 18 distal DVT (0.96%) developed but there were no clinically expressed pulmonary embolism. According to the Fisher's exact test, the difference between the complications in the analyzed groups is significant P<0.05.

Conclusions: The perioperative applying of LMWH to prevent DVT in the patients operated on gynecologically is effective.