Risk factors for bleeding complications of postoperative prophylactic anticoagulation therapy after cesarean section in preeclampsia cases

Aim: This study aimed to identify risk factors for bleeding complications of postoperative prophylactic anticoagulation after cesarean section in preeclampsia cases. Methods: A total of 68 cases of preeclampsia or superimposed preeclampsia at a tertiary perinatal center in Tokyo between 2012 and 2017 were recruited for this study. Bleeding complications were defined as subcutaneous, subfascial, or intraperitoneal hematoma detected by ultrasonography or computed tomography. Associations of clinical and laboratory data with bleeding complications were assessed by univariate and multivariate analyses. Results: Bleeding complications were recorded in nine cases: subcutaneous hematoma in four cases, subfascial hematoma in four cases, and intraperitoneal hematoma in one case. Univariate analysis revealed preoperative platelet count and 24-h urine protein level to be associated with bleeding complications. Moreover, multivariate logistic regression analysis revealed preoperative platelet count (odds ratio, 0.867; 95% confidential interval, 0.756-0.994; P = 0.04) and 24-h urine protein level (odds ratio, 1.498; 95% confidential interval, 1.031-2.176; P = 0.03) to be independent risk factors for bleeding complications. Conclusion: Preoperative platelet count and 24-h urine protein level may help to identify patients at increased risk for bleeding complications.