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Deep Vein Thrombosis and Changes in Coagulation and Fibrinolysis after Gynaecological Operations in Chinese: the Effect of Oral Contraceptives and Malignant Disease
Author(s) -
Tso S. C.,
Wong V.,
Chan Vivian,
Chan T. K.,
Ma H. K.,
Todd D.
Publication year - 1980
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1980.tb06018.x
Subject(s) - medicine , fibrinolysis , thrombosis , plasminogen activator , hysterectomy , antithrombin , venous thrombosis , deep vein , malignancy , surgery , incidence (geometry) , gastroenterology , gynecology , heparin , physics , optics
S ummary . Of 154 Chinese patients who underwent gynaecological operations, four showed a positive 125 I fibrinogen leg scan for venous thrombosis, an overall incidence of 2.6%. In those who were on oral contraceptives and had major pelvic surgery for benign conditions, the incidence was 10.5%; in those who had Wertheim hysterectomy for carcinoma of cervix, it was 6.7%. This confirms the rarity of post‐operative thromboembolism in the Chinese. Fragment E showed a biphasic rise after major operation due to tissue injury and venous thrombosis. In patients with malignancy, the postoperative ‘fibrinolytic shutdown’, represented by decreased plasminogen activator together with increased α 1 , antitrypsin and C inhibitor levels, was more marked. In addition, α 2 macroglobulin level was lower and fell significantly after operation. In patients on oral contraceptives, fragment E levels were higher after surgery and there was no decrease in plasminogen activator levels. Antithrombin III levels did not fall except in three of the four patients with venous thrombosis. A marked increase in fragment E level and a decrease in antithrombin III level might be useful diagnostic markers for postoperative venous thrombosis.