Incidence of biological intravascular coagulation in induced abortions. Postabortion hemostasis

A prospective study was designed to evaluate coagulation abnormalities induced by abortions before 10 weeks of gestation. 52 women undergoing suction abortion with diazepam-fentanyl anesthesia and spontaneous respiration were screened for coagulation parameters before and after surgery. The women ranged in age from 15-37 years and averaged 25.6. 8 tests were conducted: prothrombin time activated partial thromboplastin time thrombin time platelet count fibrinogen levels fibrin split products fibrin soluble complexes and euglobulin lysis time. The results demonstrated that statistically significant modifications occurred in 7 of the 8 parameters with activated partial thromboplastin time the only one not affected. Taken together the modifications were consistent with intravascular coagulation. It may be concluded that early aspiration abortion provokes statistically significant modifications of coagulation and fibrinolysis. The observed results were not influenced by difficulty in obtaining blood samples; cases of difficult venous puncture were excluded. Only 1 parameter was correlated significantly though weakly with pregnancy age. The absence of significant correlation between the true pregnancy age and other parameters may be explained by the early gestational ages. The observed modifications were moderate and had no clinical significance for this group of patients who had no risk factors for thrombosis and who were ambulatory soom after the procedure. In high risk patients the thrombogenic risk of induction of coagulation activation should be recognized. Preventive heparinotherapy in such cases should be considered.