Compression boots used during hip replacement operations and other major surgeries have been found to reduce the risk of blood clots for women have c-sections. The boots slip over each leg and regularly inflate and deflate, sort of like a massage, to help blood flow more briskly.
Clots known as DVTs (deep vein thrombosis) are often mistaken for mere leg pain. However, they can move up into the lungs if not treated, becoming pulmonary embolisms. Warning signs include pain or swelling in one leg, especially the calf or thigh. Redness or warmth in one spot on the leg. If the clot has reached the lung, patients will suffer from shortness of breath or chest pain.
Often triggered by obesity, as well as some birth control pills, “a woman’s risk of a DVT jumps during pregnancy and the six weeks afterward, partly because of slower blood flow from the weight gain, and because mom is less active in the last trimester and during those first few weeks of recovery from childbirth,” explained Dr. Andra James of Duke University, who co-authored the new guidelines for using the boots for the American College of Obstetricians & Gynecologists, published in the September issue of Obstetrics & Gynecology.
These guidelines urge obstetricians to closely monitor their patients for DVTs, as well as check if they have additional factors that would put them at extra risk. “Women who’ve had a DVT earlier in life, or whose close relatives had one, as well as those who have certain inherited clotting disorders, may need anti-clotting medicines throughout the pregnancy,” state James.
“Pregnancy temporarily changes blood to make it clot more easily. This is a consequence of nature’s protecting women against the bleeding challenges of childbirth. Add a C-section and, like any major surgery, it further increases that risk.”
James also noted that nearly 2 out of every 1,000 pregnant women in the US experience a deep vein thrombosis. Luckily, however, there are very few deaths from it here, although when they do occur, “those clots are one of the leading reasons.”
While the obstetricians’ group acknowledges that there haven’t been large studies with C-sections to prove how much difference the gadgets could make, it decided to recommend them anyway because in other types of surgery, the devices can cut the clot risk by two-thirds, according to James.
The guidelines recommend strapping them on before the C-section commences, “unless there’s no time before an emergency operation or the woman is taking anti-clotting medication.”
The Associated Press also reports that Mount Sinai Medical Center in Manhattan began using the devices for C-sections a few years ago, where deputy chief medical officer Dr. Erin DuPree stated that they only add $14 to the cost of care.
“Women typically remove and replace them as they ease out of bed throughout the first day after surgery, and no longer need them by the second day,” she commented. “It’s an easy thing to do that really does not cause harm and could potentially help.”
To learn more about the subject, readers are advised to contact the maternity unit at Yale-New Haven Hospital, 20 York St., New Haven, CT 06510 203 688-4242.