title: Blood loss at the time of first-trimester surgical abortion in anticoagulated women.
abstract: BACKGROUND
  The objective of this study was to compare blood loss resulting from surgical termination of pregnancy up to 12 weeks of gestation between women receiving anticoagulation therapy and healthy controls.
  
  
  METHODS
  Women using heparin, low-molecular-weight heparin or warfarin requesting surgical abortion were enrolled and prospectively matched with nonanticoagulated controls. The primary outcome was procedural blood loss. Additional outcomes included postprocedure blood loss (prior to discharge and 7 days following the procedure using standardized feminine hygiene products) and hemoglobin change (preoperative vs. Postoperative Day 1).
  
  
  RESULTS
  Four anticoagulated subjects and six control subjects were included in the analysis. The median blood loss at the time of the procedure was 70 mL (range 6-187) for the anticoagulated group and 22.5 mL (range 10-100) for the control group (p=.33). The median blood loss in the postoperative period prior to discharge was 10.5 mL (range 1-11) for the anticoagulated group and 5.5 mL (range 2-35.4) for the control group (p=.82). There were no differences in use of hygiene products or mean hemoglobin change between groups. No interventions for bleeding were necessary at the time of the procedure.
  
  
  CONCLUSIONS
  Anticoagulated women appear to have an increase in blood loss during and immediately following first trimester surgical abortion as compared to healthy controls. However, this increase does not appear to be clinically significant.
authors.affiliation: Department of Obstetrics and Gynecology, University of Hawaii, Honolulu, HI 96826, USA. bkaneshiro@ucera.org
authors.forename: Bliss
authors.initials: B
authors.lastname: Kaneshiro
authors.forename: Paula
authors.initials: P
authors.lastname: Bednarek
authors.forename: Michelle
authors.initials: M
authors.lastname: Isley
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Jensen
authors.forename: Mark
authors.initials: M
authors.lastname: Nichols
authors.forename: Alison
authors.initials: A
authors.lastname: Edelman
mesh_terms: D000028:Abortion, Induced / Q000379:methods*; D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D016063:Blood Loss, Surgical / Q000503:physiopathology*; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000503:physiopathology; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D016896:Treatment Outcome; D014859:Warfarin / Q000009:adverse effects* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D006454:Hemoglobins; D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin