title: Pelvic adhesion and gonadotropin-releasing hormone analogue: effects of triptorelin acetate depot on coagulation and fibrinolytic activities.
abstract: The study investigated the impact of gonadotropin-releasing hormone analogue (GnRH-a) on coagulation and fibrinolytic activities and its effectiveness in the prevention of pelvic adhesion after myomectomy. Thirty-two infertile women underwent myomectomy followed by adhesion evaluation surgery with a second-look laparoscopy. Before myomectomy, 15 women were treated with triptorelin acetate for 3 months and 17 received no treatment. Plasminogen activator inhibitor (PAI), thrombin activatable fibrinolysis inhibitor (TAFI), protein C (PC), plasminogen, α2-antiplasmin were determined by enzyme-linked immunosorbent assays and the activity of coagulation factors V and VIII by coagulometric methods. Patients treated with GnRH-a showed significant decrease in PAI, TAFI, factors V, and VIII (P < .05) and increased PC (P < .05), but no significant change in plasminogen and α2-antiplasmin levels compared with control group. The incidence, extent, and severity of adhesions were significantly lower in GnRH-a-treated patients compared with control group (P < .05), suggesting a possible critical role of the GnRH-a therapy in preventing postoperative adhesion development.
authors.affiliation: Department of Obstetrical-Gynecological and Urological Science and Reproductive Medicine, Federico II University, Naples, Italy. toniadinardo@yahoo.it
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Di Nardo
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Annunziata
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Ammirabile
authors.forename: Matteo Nicola Dario
authors.initials: MN
authors.lastname: Di Minno
authors.forename: Anna Lilia
authors.initials: AL
authors.lastname: Ruocco
authors.forename: Marianna
authors.initials: M
authors.lastname: De Falco
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Lieto
mesh_terms: D000328:Adult; D001777:Blood Coagulation / Q000187:drug effects*; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D006801:Humans; D007889:Leiomyoma / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care; D000267:Tissue Adhesions / Q000517:prevention & control*; D017329:Triptorelin Pamoate / Q000008:administration & dosage*; D014594:Uterine Neoplasms / Q000601:surgery
chemical_list: D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone