Prevention, diagnosis, and treatment of venous thromboembolic complications of gynecologic surgery

Deep vein thrombosis and pulmonary embolism, collectively referred to as venous thromboembolic events, are a source of significant morbidity and mortality after gynecologic surgical procedures. In this literature review the advantages and disadvantages of various preventive measures for deep venous thrombosis, including low-molecular-weight heparins, are discussed. The most appropriate prophylactic methods for patients in varying risk categories are recommended. Current methods of diagnosing deep venous thrombosis and pulmonary embolism, including ultrasonography, venography, ventilation-perfusion scan, helical computed tomographic scan, and -dimer measurement are then discussed. Finally, treatment modalities for deep venous thrombosis and pulmonary embolism, including heparin, low-molecular-weight heparin, warfarin, and thrombolytic therapy, are detailed. (Am J Obstet Gynecol 2001;184:759-75.)