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Blood loss at the time of first trimester surgical abortion in anticoagulated women

Bliss Kaneshiro, Oregon Health Sciences University, 2007
See also executive summary and publication in Contraception.

Project abstract

In 2002, there were 1.29 million induced abortions in the United States (1). Indeed, induced abortion has been cited as the most common surgical procedure in the United States (2). Because of its commonality, clinicians who provide this service are sometimes faced with the dilemma of performing a surgical procedure on women who are anticoagulated. While first trimester surgical abortion is a safe procedure associated with minimal blood loss, there are no published studies examining blood loss at the time of surgical termination of pregnancy in women who are anticoagulated. The importance of maintaining anticoagulation varies with the indication for anticoagulation. However, interruption of therapy, even for a short time, increases the risk of thromboembolism, especially in pregnant women (3).

At our facility, senior abortion providers perform surgical abortions on women who are anticoagulated without interrupting anticoagulant therapy. Although the possibility for intraoperative hemorrhage is always present, they have not noted a clinically significant increase in blood loss during these procedures. This study is based on the hypothesis that anticoagulant therapy does not increase intraoperative blood loss in women receiving surgical abortions up to 12 weeks gestation.

We propose a prospective pilot study at two sites in the United States. The primary objective of this study is to compare blood loss resulting from surgical termination of pregnancy up to 12 weeks gestation between women who are anticoagulated to therapeutic levels and those who are not anticoagulated.

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