Thromboprophylaxis in women undergoing gynecological surgery or assisted reproductive techniques: new advances and challenges

Abstract

Venous thromboembolism (VTE) affects 0.1–0.3% people each year. The risk of VTE following gynecological surgery and invasive procedures is well established and presents one of the major challenges in gynecological practice. Moreover, commonly use assisted reproductive techniques (ART) are reported to increase the risk of VTE. Despite continued efforts to reduce its incidence, postoperative VTE remains the second most common perioperative complication and the third most common cause of mortality.
Several practice guidelines have been developed regarding prophylaxis and treatment of VTE. However, there is a large inconsistency between the recommendations and the medical practice in various centers. Moreover, prophylaxis in gynecological patients and women undergoing ART should be chosen individually for the patient, taking into account the possible risk factors for VTE and perioperative bleeding complications. Until recently, the percentage of women, who have not received anticoagulant prophylaxis or administrated it inadequately may reach 50%.
This paper presents the current recommendations regarding thromboprophylaxis in women undergoing gynecological
surgery or assisted reproductive techniques and addresses challenging practical issues in this field.