COMPARISON OF LOW-MOLECULAR-WEIGHT HEPARIN (FRAGMIN) WITH SODIUM HEPARIN FOR PROPHYLAXIS AGAINST POSTOPERATIVE THROMBOSIS IN WOMEN UNDERGOING MAJOR GYNECOLOGICAL SURGERY

A randomized controlled trial was undertaken comparing the efficacy an d safety of low molecular weight (LMW) heparin (Fragmin) with sodium h eparin for prophylaxis against postoperative thromboembolic disease af ter major gynaecological surgery. Women were randomized to receive sub cutaneous injections of 5,000 U of either once daily LMW heparin or tw ice daily sodium heparin. A total of 566 women were recruited, of whom 552 completed the study. Most women (461) had malignant disease and 4 30 of these underwent radical surgery. The remainder underwent major, but not radical surgery. There were 5 thromboembolic events in the LMW heparin group and 2 in the sodium heparin group, with no significant difference between these groups. No significant difference was found i n the incidence of intraoperative or postoperative transfusion in the 2 groups. The decision of which heparin to use in routine practice can not be made on clinical grounds.