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percent in Bali, Indonesia [37]. The difference in importance
is only because in the developed countries, the other common
causes of death such as infection and haemorrhage have been
sUfficiently controlled.
Risk factors which have been identified to predispose to
pregnancy-related thrombosis include: age greater than 35
years 1 high parity 1 obesity: prolonged ilMlobility and
operative delivery [ 13 8 ] . One case report also questioned the
role of sickle cell ateeaee in causing recurrent and fatal
puerperal thrombophlebitis ( 1 39 ].
The incidence of puerperal thrombosis in Africa and
Asia. is stated to be about 0 .1%, much l owe r than ene rates in
the industrialised countries [43] . Thrombosis and its
complications are not an easy conditions to diagnose
clinically and often require expensive and sophisticated
diagnostic tools [ l40) . These tools are no t available in poor
developing wor ld hospitals. It is possible, therefore , that
the reported low incidence in these poor countries , may be
because the co ndition is under-diagnosed, in addition t o its
being under-reported i n t hes e settings.
51
In support of this view a re the findings of studies dono
on postoperative SUbjects in some developing countries which
used sophisticated diagnostic t echn i q ue s . These studies found
the incidences of thrombosis to be s imilar to those in the