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 journalArticle

3 Citations (Scopus)

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)
JournalContraception
DOIs
StateAccepted/In press - Jan 28 2016

Fingerprint

Anticoagulants
Hemorrhage
Surgical Blood Loss
Pregnancy
International Normalized Ratio
Low Molecular Weight Heparin
Warfarin
Blood Transfusion
Heparin
Therapeutics

Keywords

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

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Blood loss at the time of surgical abortion up to 14 weeks in anticoagulated patients : A case series. / Kaneshiro, Bliss; Tschann, Mary; Jensen, Jeffrey; Bednarek, Paula; Texeira, Ronnie; Edelman, Alison.

In: Contraception, 28.01.2016.

Research output: Contribution to journalArticle

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AU - Texeira, Ronnie

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