Fibrinolytic activity in bleeding associated with intrauterine contraceptive devices
Khanna, A.; Biswas, A.K.; Dubey, B.; Khanna, A.K.
Indian Journal of Medical Research 96: 147-149
1992
ISSN/ISBN: 0019-5340 PMID: 1512035 Document Number: 323589
During 1987-1988, physicians followed 150 endometrial biopsy patients at the Institute of Medical Sciences of Banaras Hindu University in Varanasi, India, who used the copper 250 IUD (Multiload) to examine fibrinolytic activity of the endometrium. They divided the women into 3 groups: group I--62 women seeking an IUD and who had no menstrual complaints (control group); group II--40 women wanting the IUD removed for reasons other than bleeding; group III-48 women wanting the IUD removed for menorrhagia. A fibrin plate in the form of Zone of lysis was used to measure fibrinolytic activity. The area of lysis in the control group varied from 0.3-9.5 sq. cm, with the 1.1-2 sq. cm area of lysis being the most common area (37%), followed by 2.1-3 sq. cm (29%) and 0-1 sq. cm (25.8%). Group II women experienced more fibrinolytic activity than the control group (mean 1.77 sq. cm vs. 2.28 sq. cm), but the difference was insignificant. On the other hand, fibrinolytic activity was significantly higher in group III (mean 4.75 sq. cm, range 2.24-7.56 sq. cm) than in groups I and II (p .001). The most common area of lysis in group III was 5.1.6 sq. cm (33.3%), followed by 3.1-4 sq. cm and 4.1-5 sq. cm, each amounting to 25%. The 2.5 times higher fibrinolytic activity in women experiencing menorrhagia demonstrated that excess bleeding is closely linked to endometrial hyperfibrinolysis brought about by insertion of an IUD. This finding motivated the physicians to suggest administration of antifibrinolytic drugs to IUD users beginning with the first cycles to reduce IUD discontinuation.