Pulmonary thromboembolism following gynecologic surgery and cesarean section

Objective: To investigate the incidence and risk factors of symptomatic pulmonary thromboembolism (PTE) in patients following gynecologic surgery or cesarean section in Japan. Method: We examined the clinical records of all patients who have undergone gynecologic surgery or cesarean section at 32 hospitals affiliated with the Tohoku University Hospital between 1990 and 1999. Result: The total number of gynecologic surgical procedures and cesarean sections were 61648 and 26502, respectively. Twenty-five of the 88150 (0.028%) patients developed clinical PTE. Among the PTE patients who underwent gynecologic surgery, 86% were more than 40 years of age, 36% were obese (BMI>25 kg/m²) and 43% had uterine body cancer. Among the PTE patients who underwent cesarean section, 36% were more than 35 years of age and 55% were obese (BMI>29 kg/m²). Conclusion: Risk factors in Japanese patients undergoing gynecologic surgery may include age and cancer of the uterine body; risk factors for the development of PTE following cesarean section may include age and obesity.