New advice for pregnant women: If you're getting a C-section, special inflating boots
strapped on your legs may lower the risk of a blood clot. Hospitals already use these
compression devices for other major operations, such as hip replacements, and a
growing number have begun offering them for at least some of their cesarean deliveries,
too.
These clots make headlines every few years when seemingly healthy people collapse
after long airplane flightsor similar prolonged inactivity. Certain surgeries also can trigger
a DVT. Earlier this year, tennis star Serena Williams was treated for clots in her lungs
discovered after foot surgery and cross-country travel.
obstetricians say it's time to make the step routine for most C-sections, which account
for nearly a third of U.S. birthsThe new recommendations promise to raise awareness
of what is a silent threat not just for pregnant women but for thousands of other people,
too: Blood clots in veins that can masquerade as simple leg pain.Called a DVT, for deep
vein thrombosis, this kind of clot usually starts in the leg or groin. But it can kill if it moves
up to the lungs, where it's called a pulmonary embolism.Fortunately, pregnancy-related
deaths are very rare in this country, but when they happen, those clots are one of the
leading reasons.Yet too few people even know the warning signs, she says: 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, shortness of breath or chest pain.The new guidelines urge
obstetricians to closely monitor their patients for DVTs — and to 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 — or who have certain inherited clotting disorders
— may need anti-clotting medicines throughout the pregnancy,
say the recommendations, published in the September issue of the journal
Obstetrics & Gynecology.Then there are those compression devices, which slip over
each leg and regularly inflate and deflate, sort of like a massage, to help blood flow more
briskly.The obstetricians' group acknowledges that there haven't been large studies with
C-sections to prove how much difference the gadgets could make. But it decided to
recommend them anyway because in other types of surgery, the devices can cut the clot
risk by two-thirds, James says.The guidelines recommend strapping them on before the
C-section begins, unless there's no time before an emergency operation or the
woman is taking anti-clotting medication.Mount Sinai Medical Center in New York
began using the devices for C-sections a few years ago, and deputy chief medical
officer Dr. Erin Now guidelines for the nation's
