Deep vein thrombosis and changes in coagulation and fibrinolysis after gynaecological operations in Chinese: the effect of oral contraceptives and malignant disease
Tso, S.C.; Wong, V.; Chan, V.; Chan, T.K.; Ma, H.K.; Todd, D.
British Journal of Haematology 46(4): 603-612
1980
ISSN/ISBN: 0007-1048 PMID: 7437338 DOI: 10.1111/j.1365-2141.1980.tb06018.xDocument Number: 460427
Of 154 Chinese patients who underwent gynecological operations, 4 showed a positive 125I 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 .alpha.1 antitrypsin and C1-inhibitor levels, was more marked. In addition, .alpha.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 3 of the 4 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.