ArticleResearch and practice in thrombosis and haemostasis2026
Evaluation of the clinical performance of a risk scoring model for venous thromboembolism prophylaxis in cesarean section for a largely Chinese population.
Article in Research and practice in thrombosis and haemostasis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Recommendations for venous thromboembolism (VTE) prophylaxis after cesarean section (CS) from authoritative guidelines differed significantly and may not be applicable to Chinese population. Objectives: This study aimed to evaluate the performance and safety of an adapted risk score prophylaxis protocol in a largely Chinese cohort. Methods: The risk assessment and preventive care for VTE for CS protocol was implemented from May 2017 for all patients undergoing CS. Those with moderate risk (VTE score, 2) would be prescribed mechanical prophylaxis using pneumatic cuff, and those with high risk (VTE score, ≥3) would be prescribed pharmacologic prophylaxis with low-molecular-weight heparin in addition to the pneumatic cuff. In this retrospective cohort study, the outcome of patients with CS from the time of implementation of the protocol to December 2024 (7.5 years) was compared with that of a preprotocol group with no prophylactic measures from January 2014 to April 2017. Results: Among 4803 patients with CS in the protocol period, 633 (13.2%) women were prescribed mechanical prophylaxis and 156 (3.25%) patients required pharmacologic prophylaxis. Recoding the risk scores under the Royal College of Obstetricians and Gynaecologists or American College of Chest Physicians guidelines showed that 78.9% and 27.1% would require pharmacologic prophylaxis, respectively. There were 5 patients with VTE events in the protocol group compared with 11 among 3309 CS patients in the preprotocol group. The observed incidence of postpartum VTE significantly dropped from 0.33% to 0.1% after the implementation of the protocol ( Conclusion: Implementation of a standardized thromboprophylaxis protocol adapted for cesarean deliveries in our local obstetric population maintained pharmacologic thromboprophylaxis at a low rate and did not result in an increase in bleeding complications. A lower incidence of VTE was observed after implementation of the protocol than that in the preprotocol period.
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