Abstract Number: PB1202
Meeting: ISTH 2021 Congress
Background: Venous thromboembolism (VTE) has been a leading cause of direct maternal deaths in the U.K. for over two decades. Venous thrombosis (VT) commonly affects the deep veins of the lower limbs but can occur in unusual sites such as the vena cava, abdomen/pelvis and upper limbs. With improved gynaecological imaging, pelvic thrombi can also be detected on transvaginal ultrasound (TVS).
Aims: To determine the prevalence of uterine venous plexus thrombosis (UVPT) in women attending gynaecology clinic and identify potential risk factors.
Methods: A prospective observational, cross-sectional study was conducted within a gynaecology clinic setting at a university teaching NHS hospital in London, U.K. over a 16-month period. Women presented with a variety of symptoms and were recruited by a single operator. The diagnosis of UVPT was based on established criteria for thrombi. The exclusion criteria included: age <18 years, unable to undergo TVS, previous hysterectomy. Women diagnosed with UVPT were managed in conjunction with the haematologists and had thrombophilia screening and lower limb venous duplex imaging.
|Demographic information||UVPT (N = 39)||No UVPT (N = 1259)|
|Age||44·7 ± 10·1||42·8 ± 12·5|
|Parity 0||8 (20·5%)||573 (45·5%)|
|Parity 1||7 (18·0%)||231 (18·4%)|
|Parity 2||10 (25·6%)||245 (19·5%)|
|Parity >3||14 (35·9%)||210 (16·7%)|
|Pre-menopausal||33 (84·6%)||977 (77·6%)|
|Post-menopausal||6 (15·4%)||282 (22·4%)|
|History of VTE||1 (2·6%)||21 (1·7%)|
We screened 1,298 women and 39 women were diagnosed with UVPT, giving a prevalence of 3.0% (95% CI, 2.1-4.1 %). Demographic data are shown in Table 1. Multivariate analysis for UVPT risk factors showed significant associations between multiparity, pre-menopausal status, recent surgery, presence of leg varicose veins and a family history of venous thromboembolism. Thrombophilia was detected in 12.8% women with UVPT.
Conclusions: The prevalence of UVPT in a general gynaecological population was 3.0%. Several demographic and clinical factors were found to be associated with UVPT, which could help to identify women at risk of this condition and facilitate its early detection. This would provide a basis to assess the natural history and clinical significance of this novel clinical finding, and the development of an optimal management approach.
To cite this abstract in AMA style:Amin T, Cohen H, Wong M, Jurkovic D. How Common Are Uterine Venous Plexus Thrombi in Women Attending the Gynaecology Clinic? [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/how-common-are-uterine-venous-plexus-thrombi-in-women-attending-the-gynaecology-clinic/. Accessed November 29, 2021.
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