Pulmonary thromboembolism in obstetrics and gynecology increased by 6.5-fold over the past decade in Japan

Background Although pulmonary thromboembolism (PTE) has been considered relatively uncommon in Japan, its incidence has been on the increase in recent years. Methods and Results To verify the incidence of PTE in Japan, PTE cases of obstetrics and gynecology were investigated among 102 facilities throughout Japan between 1991 and 2000. A total of 254 cases were enrolled, showing a 6.5-fold increase over the past 10 years. PTE occurred in 0.02% of total births; 0.003% after vaginal deliveries and 0.06% after cesarean births (C/S), of which 14.5% resulting in fatality. The mortality rate was 2.5 per 100,000 deliveries. The incidences among gynecological cases were 0.08% of total operations; 0.03% in benign diseases and 0.42% in malignant diseases of which 13.5% resulting in fatality. The mortality rate was 10.8 per 100,000 operations. The risk was 22 times higher in C/S compared with vaginal deliveries, 16 times higher in malignant diseases compared with benign diseases. Conclusions As our present survey has shown, PTE has been on the rise in Japan in recent years. C/S and malignant diseases are strong risk factors in obstetrics and gynecology.