OGCO-E28 Thromboprophylaxis for surgery in general gynaecology

Question 1

Who requires pharmacological anticoagulation for gynaecological surgeries?

Answer 1

Patients undergoing major gynaecological surgeries >60 mins regardless of operative route, routine pneumatic compression during operation is recommended.

Undergoing minor or intermediate operations (<60 mins), thromboprophylaxis is not required.

Question 2

What are the RF for using thromboprophylaxis with LMWH?

Answer 2

Question 3

What are the contraindications to LMWH thrombroprophylaxis?

Answer 3

• Active bleeding
• History of heparin-induced thrombocytopenia
• Platelet count <100 x 109
• Abnormal renal function

Question 4

What regimen for thromboprophylaxis in general gyn surgery?

Answer 4

Enoxaparin 40mg 2 hours before operation on day of admission, followed by 40mg q24h haemostasis achieved until patient mobilizing well/discharge