Complications of low-dose heparin prophylaxis in gynecologic oncology surgery.
The clinical and laboratory effects of low-dose heparin prophylaxis was prospectively studied in a controlled trial of 182 patients undergoing major surgery for gynecologic malignancy. Low-dose heparin was given in 5000 U subcutaneously two hours preoperatively and every 12 hours for seven days postoperatively. Low-dose heparin-treated patients had a significantly increased daily retroperitoneal hemovac drainage. Although not statistically significant, low-dose heparin was associated with increased estimated intraoperative blood loss, transfusion requirements, and wound hematomas. Fifteen percent of patients receiving low-dose heparin were found to have an activated partial thromboplastin time greater than 1.5 times the control value. In these patients, all clinical bleeding parameters were significantly increased. Low-dose heparin-treated patients also had significantly prolonged activated partial thromboplastin time and lower final platelet counts as compared with the control patients. When using low-dose heparin for thromboembolism prophylaxis, patients should be closely observed for clinical hemorrhagic complications. Activated partial thromboplastin times and platelet counts should be monitored throughout therapy.
D000328:Adult; D000368:Aged; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006470:Hemorrhage / Q000139:chemically induced*; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007279:Injections, Subcutaneous; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000517:prevention & control; D013923:Thromboembolism / Q000517:prevention & control*; D013924:Thrombophlebitis / Q000517:prevention & control
D005338:Fibrin Fibrinogen Degradation Products; D006493:Heparin