Epidemiology of deep venous thrombosis during pregnancy and puerperium in Sudanese women

BACKGROUND Deep venous thrombosis (DVT) and venous thromboembolism (VTE) is a major health problem with high mortality worldwide. Patients at risk must be identified and given appropriate prophylaxis in order to decrease the mortality. OBJECTIVE To investigate the prevalence of DVT in pregnancy and the puerperium and to identify risk factors for DVT. SETTING Khartoum and Khartoum North Teaching hospitals, Sudan. DESIGN Case-control study. RESULTS During the study period (April 2007-March 2008), 65 patients presented with DVT as confirmed by Doppler ultrasound. A total of 14,490 deliveries occurred during the study period. The rate was 448 DVT per 100,000 births/year. Only four of these 65 patients were pregnant and the rest presented at postpartum. DVT occurred in the left lower extremity in 51 (78.4%), in the right in 13 (20.0%), and in one (1.5%) woman in both legs. In univarite and multivariate analyses, family history of DVT, primigravidae and cesarean section deliveries showed an higher risk of DVT. CONCLUSIONS The study showed a high prevalence of DVT, most of these events occurred in the postpartum period. Primiparae, family history of DVT and cesarean section deliveries were important risk factors and these groups are candidate for prophylaxis measures against DVT.