C-section carries a 4-fold increased risk of blood clots, compared with vaginal deliveries

MedicalResearch.com Interview with:
Marc Blondon, MD
Division of Angiology and Hemostasis, Department of Specialties of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle, WA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Venous thromboembolism, a condition including deep vein thrombosis (blood clots) and pulmonary embolism, is more common in older than younger patients. However, pregnancy and particularly the postpartum period are times at greater risk of blood clots in women. It is important to understand the risk and the risk factors for thrombosis in the postpartum period to guide the use of preventive measures such as heparin, an anticoagulant treatment, or leg compression devices.

Our study summarizes the evidence on the link between C-sections and blood clots from the past 35 years.
Our meta-analysis demonstrates that:

  • C-section carries a 4-fold increased risk of blood clots in the postpartum period, compared with vaginal deliveries ;
  • that this risk is most prominent but not restricted to emergency C-section ;
  • and that women who undergo elective C-section are also at higher risk than women who have a vaginal delivery.
  • Importantly, we estimated an absolute risk of blood clots after a C-section of 2-4 per 1000 pregnancies: on average, 3 out of 1000 women after C-section will develop a blood clot.

MedicalResearch.com: What should readers take away from your report?

Response: Even though C-section increases the risk of blood clots, this risk remains low and the vast majority of women will not develop this condition.
However, women should take this increased risk of blood clots into account if they consider a cesarean delivery without a medical indication.
We also suggest that women should discuss the issue of venous thrombosis with their care providers / obstetrician to plan for possible preventive measures in the postpartum period. Because other conditions than C-section may increase the risk of blood clots, this discussion is important in all pregnant women.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: The risks and benefits of heparin to prevent blood clots are well known from surgical and medical patients, but not specifically in women in the postpartum period. A study comparing heparin to no treatment would require an important collaboration of multiple centers, but would be very useful to care providers and patients. Our study emphasizes the need for such a study.

In the United States, most prevention measures are mechanical, with the use of compression stockings for example. However, while we expect that they reduce blood clots, the utility of compression stockings or other devices is unclear and further research would be welcome.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Risks of Venous Thromboembolism After Cesarean Sections: A Meta-Analysis

Marc Blondon, MD,  Alessandro Casini, MD, Kara K. Hoppe, DO,  Françoise Boehlen, MD, Marc Righini, MD,  Nicholas L. Smith, PhD

Chest Volume 150, Issue 3, September 2016, Pages 572–596

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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