beta-escin and Genital-Diseases--Female

Eight prospective, controlled, randomised studies on the incidence of postoperative thrombosis in gynaecological patients receiving various drugs for prevention of thromboembolism are analysed. In all patients diagnosis had been established by objective means. The rate of thrombosis in patients without drug prophylaxis has been found to vary between 14 and 29%. Infusions of dextran as well as administration of low-dose subcutaneous heparin significantly reduce the incidence of deep vein thrombosis, even as compared to postoperative oral anticoagulation with cumarins. No difference has been found between dextran and oral anticoagulants, when cumarin adminstration was started before operation, nor between dextran and heparin. Aescin did not show any prophylactic effect. High age, severe leg-vein varicosis as well as surgery for malignant disease increase the risk of thrombosis. No significant influence of overweight, previous deep venous thrombosis, epidural anaesthesia or vaginal operation as compared to abdominal approach could be demonstrated. There are no properly controlled, prospective, randomised studies on the incidence of postoperative fatal pulmonary embolism as influenced by drugs in gynaecological surgery.

Topics: Age Factors; Anesthesia; Dextrans; Escin; Female; Genital Diseases, Female; Heparin; Humans; Obesity; Postoperative Complications; Thromboembolism; Thrombophlebitis; Varicose Veins

The effectiveness of low-dose heparin has been compared with other methods of thrombo-embolism prophylaxis, on the basis of 892 gynaecological operations. No case of acute venous thrombosis or lethal pulmonary embolism was established in the Infukoll-M-40 group. No effective prophylaxis against thrombo-embolism was obtainable from acetylsalicylic acid (Micristin). More postoperative bleeding was recorded from the low-dose heparin group. Two far-reaching thromboses and three cases of lethal pulmonary embolism occurred in the wake of low-dose heparin prophylaxis. The most favourable effect, in terms of preventing postoperative leg thrombosis and pulmonary embolism, was recorded from low-molecular dextran (Infukoll M 40). Anaphylactoid reactions, such as bronchospasm, flush, urticaria, and hypotension, were not observed. A therapy standard for gynaecological operations is recommended, with reference being made to the authors' own findings.

Topics: Aspirin; Dextrans; Dose-Response Relationship, Drug; Escin; Female; Genital Diseases, Female; Heparin; Humans; Postoperative Complications; Thromboembolism

Topics: Edema; Escin; Female; Genital Diseases, Female; Genital Neoplasms, Female; Humans; Saponins; Uterine Cervical Neoplasms; Uterine Neoplasms