Characteristics of the functional status of hemostasis in women after type I hysterectomy according to their body mass index

Abstract

Neoplastic processes are a pathogenic trigger for the development of thrombotic complications, including deep vein thrombosis and pulmonary artery thromboembolism. Post-operative thrombosis is one of the leading mortality causes of oncological patients due to its asymptomatic course, and therefore due to the late diagnosis and treatment.

Purpose — to estimate the coagulation system condition in women after the type I hysterectomy depending on their body mass index.

Materials and methods. The study of hemostasis parameters of 50 patients with the uterus and uterine appendages oncological diseases depending on the body mass index was carried out. The results were processed by the method of variation statistics, which became the basis for their generalization. Calculations of the parametric Student's t-test and methods of nonparametric statistics (Mann–Whitney test) were used. Differences between comparable parameters were found statistically significant at p<0.05.

Results. The analysis of hemostasis parameters in oncological patients has revealed a twice higher concentration of fibrinogen and soluble fibrin monomer complexes in comparison to the control group. All three groups were characterized by hyperthrombocytopenia. The surgery provoked further activation of I, II, and III phases of coagulation on the background of negative thrombodynamics caused by intraoperative blood loss. In women with I and II obesity grade no statistically significant differences in coagulogram were observed, whereas in patients with III obesity grade the thrombotic potential was significantly more aggressive.

Conclusions. Oncological diseases of the female reproductive system are associated with the impairment of coagulation status: lower activated partial thromboplastin, hyperfibrinogenemia, and increased prothrombin index. The surgery was a significant trigger of the increase of hemostatic potential with the progressive increase of the markers of I, II, and III coagulation phases. III obesity grade is an independent risk factor for thrombotic complications.

The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of all participating institution. The informed consent of the patient was obtained for conducting the studies.

No conflict of interest was declared by the authors.