Blood loss at the time of surgical abortion up to 14 weeks in anticoagulated patients: a case series

Bliss Kaneshiro, Mary Tschann, Jeffrey Jensen, Paula Bednarek, Ronnie Texeira, Alison Edelman

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objective To describe estimated blood loss (EBL) with surgical abortion ≤14 weeks’ gestation in anticoagulated patients. Study design We invited 170 clinicians involved in a professional listserv to report cases when they performed a surgical abortion on a patient ≤14 weeks’ gestation taking an anticoagulant. Clinicians reported EBL and bleeding-related complications (need for a blood transfusion, additional surgical procedures to treat bleeding). We contacted clinicians 30 days postprocedure to capture postoperative complications. Results Clinicians reported 52 cases between February 2011 and October 2013. Thirty percent of patients (16/52) stopped the anticoagulant with adequate time for the effects to abate prior to surgery (6 h for heparin, 24 h for low-molecular-weight heparin, International Normalized Ratio ≤1.7 the day prior to surgery for warfarin), while 69% (36/52) continued the anticoagulant either at therapeutic (25/36) or subtherapeutic (16/36) doses. Seventy-eight percent (28/36) of patients who continued the anticoagulant had an EBL of 50 mL or less compared to 88% (14/16) of those who stopped the anticoagulant with adequate time for its effects to abate (p=.73). Bleeding-related complications occurred in four anticoagulated patients and none of the patients who discontinued anticoagulant therapy. Conclusion Continuation of anticoagulation for planned surgical abortion under 84 days does not appear to be associated with heavy bleeding.

Original languageEnglish (US)
Pages (from-to)14-18
Number of pages5
JournalContraception
Volume96
Issue number1
DOIs
StatePublished - Jul 2017

Keywords

  • Abortion
  • Anticoagulation
  • Bleeding
  • Heparin
  • Low molecular weight heparin
  • Warfarin

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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