Perioperative Changes in Plasma Antithrombin Activity and Platelet Counts in Patients Undergoing Gynecologic Surgery

Abstract

The relationships among perioperative changes in plasma antithrombin (AT) activity, platelet counts, and clinical risk factors for postoperative thromboembolism has not been studied extensively in gynecologic patients. AT activity and platelet counts were determined preoperatively and on postoperative days 1 and 7 in 74 patients who underwent gynecologic surgery. The relationships between each clinical risk factor for postoperative thromboembolism and the decrease in AT activity and platelet count were analyzed using a univariate logistic regression model. No clinically significant thromboembolism occurred in any patient. AT activity and platelet counts decreased significantly on postoperative day 1 and exceeded preoperative levels on day 7. Postoperative patients with malignancy were more likely to exhibit decreased AT activity. AT activity decreased significantly with increases in operating time and blood loss. Known risk factors for postoperative thromboembolism did not appear to be associated with postoperative decreases in platelet counts. Transient hyperconsumption of AT and platelets occurs immediately after gynecologic surgery. Surgery-induced AT deficiency may contribute to postoperative thromboembolism in patients with long operating times and significant blood loss.

Prolonged activated partial thromboplastin time in thromboprophylaxis with unfractionated heparin in patients undergoing cesarean section

“…Hemorrhage may also reduce the amount/concentration of anticoagulation factors. For example, our previous data showed a decrement in antithrombin activity after heavy hemorrhage during gynecological surgery 14 . Although the mechanism is unknown, massive hemorrhage may not preclude heparin‐thromboprophylaxis after CS within a range, although this range has not been determined.…”

Platelet Count Predicts Adverse Clinical Outcomes After Ischemic Stroke or TIA: Subgroup Analysis of CNSR II

“…However, all platelet indexes results should be comparable because platelet count measurement in each center were performed according to recommendation of International Federation of Clinical Chemistry and Laboratory Medicine (2011). Finally, residual confounding factors from comorbidities or environment may still exist and influence circulating platelet indexes, such as tumor, blood disease, and acute toxicosis (25, 26).…”