title: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical School, Minamikawachi-machi, Tochigi-ken, 329-0498 Japan. twatnabe@jichi.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Akihide
authors.initials: A
authors.lastname: Ohkuchi
authors.forename: Hisanori
authors.initials: H
authors.lastname: Minakami
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Sakata
authors.forename: Shigeki
authors.initials: S
authors.lastname: Matsubara
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Wada
authors.forename: Tamaho
authors.initials: T
authors.lastname: Onagawa
authors.forename: Ikuo
authors.initials: I
authors.lastname: Sato
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage; D000991:Antithrombins / Q000378:metabolism*; D016063:Blood Loss, Surgical; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D010976:Platelet Count; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology; D011247:Pregnancy; D012307:Risk Factors; D013923:Thromboembolism / Q000097:blood / Q000209:etiology
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D006493:Heparin