Plasma level of D-dimer accompanying different types of gynecologic surgery and effects of prophylactic subcutaneous injection of heparin calcium
Keywords:D-dimer, DPE, POD-1, Gynecologic surgery, Heparin calcium
Background: The standard range of D-dimer level associated with each type of gynecologic surgery is required to note the occurrence of bleeding or thromboembolism.
Methods: Plasma levels of D-dimer of patients who underwent different types of gynecologic surgery were measured on the Day of Preoperative Examination (DPE) and the first postoperative day (POD-1). Patients were classified by surgery type: hysterectomy for benign diseases or cervical intraepithelial neoplasia; hysterectomy for uterine cancer; surgery for ovarian cancer; laparoscopic surgery for a benign adnexal mass; laparotomy for a benign adnexal mass; laparotomic myomectomy; cervical conization; transcervical resection of an intrauterine mass; vaginal surgery for prolapse of a pelvic organ.
Results: In each type of gynecologic surgery, plasma levels of D-dimer on POD-1 were higher than those on the DPE. Prophylactic subcutaneous injection of heparin calcium for patients who underwent surgery for endometrial cancer showed no significant difference in the plasma level of D-dimer on the sixth postoperative day (POD-6) and the plasma level of D-dimer on POD-6 was in the same level as those on POD-1.
Conclusions: Plasma levels of D-dimer on POD-1 were higher than those on the DPE in each type of gynecologic surgery. The D-dimer level remained high even on POD-6, and not changed by prophylactic subcutaneous injection of heparin calcium.
Adam SS, KeyNigel NS, Greenberg CS. D-dimer antigen: current concepts and future prospects. Blood. 2009;113:2878-87.
Davis JD. Prevention, diagnosis, and treatment of venous thromboembolic complications of gynecologic surgery. Am J Obstet Gynecol. 2001;184:759-75.
Kodama J, Seki N, Fukushima C, Kusumoto T, Nakamura K, Hiramatsu Y. Postoperative decreased levels of D-dimer in patients with genecologic cancer with enoxaparin and fondaparinux thromboprophylaxis. Molec Clin Oncol. 2013 Jul;1(4):737-44.
Payen JF, Baruch M, Horvilleur E, Richard M, Gariod T, Polack B. Changes in specific markers of haemostasis during reduction mammoplasty. Br J Anaesth. 1998;80:464-6.
Hughes SF, Hendricks BD, Edwards DR, Bastawrous SS, Middleton JF. Lower limb orthopaedic surgery results in changes to coagulation and non-specific inflammatory biomarkers, including selective clinical outcome measures. Eur J Med Res. 2013;18:40.
Vreeburg EM, Levi M, Rauws EAJ, Deventer SJHV, Snel P, Bartelsman JWFM, et al. Enhanced mucosal fibrinolytic activity in gastroduodenal ulcer haemorrhage and the beneficial effect of acid suppression. Aliment Pharmacol Ther. 2001;15:639-64.