Deep-Vein Thrombosis Is Associated with Large Uterine Fibroids

Abstract

Pulmonary thromboembolism (PE) may occur upon a patient's first postoperative attempt of ambulation. PE is a serious complication, often leading to shock or sudden death. Reported rates of PE following gynecologic surgery are between 0.3% and 0.8%, while the incidence of postoperative deep-vein thrombosis (DVT), the major cause of PE, is between 17% and 20%. Therefore, effective preventive measures, such as preoperative assesment for asymptomatic DVT, should be considered. It is well known that DVT and/or PE are associated with large uterine fibroids, the common, benign tumor of myometrium. Here, to establish the statistical relationship between DVT risk and uterine fibroid size/weight, we assessed the preoperative DVT rate with respect to three possible risk factors: age, obesity level, and uterine size/ weight. A total of 361 patients with uterine fibroids undergoing hysterectomy between July, 2003 and December, 2009 were enrolled. All patients were evaluated for preoperative DVT; the results were stratified for statistical comparison by patient age, BMI, and uterine weight. There was no statistical difference in the DVT rate for patients stratified by age (below age 45 years or older) or BMI (below 25 or higher). By contrast, the rate of DVT was significantly higher for patients with uterine weights of 1,000 gm or more (11.5% [7/61]) compared with weights below 1,000 gm (3.0% [9/300]). None of the patients studied developed PE. In conclusion, the incidence of DVT is significantly higher in cases where uterine weight is 1,000 gm or more (ie, adult head size on pelvic examination).

Risk Factors for Deep-Vein Thrombosis and Pulmonary Thromboembolism in Benign Ovarian Tumor

“…Some malignancies are known to increase coaguability, and DVT/ PE has been reported in patients with ovarian cancer (Suzuki et al 2010). An increased risk of DVT has also been demonstrated in patients with large uterine fibroids, possibly due to compression of adjacent blood vessels including the inferior vena cava (Shiota et al 2011). Suzuki et al (2010) have reported an incidence rate of 3.17% for perioperative DVT in women with surgical gynecological disease, including patients with malignant tumors.…”

“…Suzuki et al (2010) have reported an incidence rate of 3.17% for perioperative DVT in women with surgical gynecological disease, including patients with malignant tumors. In patients with benign gynecologic diseases, such as uterine fibroids, the size of the mass has been found to be a factor for increased risk of DVT (Shiota et al 2011). If these large masses compress the inferior vena cava and other pelvic veins, the resulting venous stasis may lead to DVT (Shiota et al 2011).…”

“…In patients with benign gynecologic diseases, such as uterine fibroids, the size of the mass has been found to be a factor for increased risk of DVT (Shiota et al 2011). If these large masses compress the inferior vena cava and other pelvic veins, the resulting venous stasis may lead to DVT (Shiota et al 2011).…”

“…Suzuki et al (2010) have suggested that ovarian cancers ≥ 10 cm in diameter and the history of previous venous thromboembolic episodes might be pertinent risk factors. Shiota et al (2011) have reported that in patients with benign uterine fibroids, larger tumor diameter is associated with increased risk of DVT, most likely because of venous compression by the mass. Age and obesity were not related to the incidence of DVT in these patients.…”

Extensive Left Iliac Veins and Inferior Vena Cava Thrombosis Revealing a Giant Uterine Myoma

“…An association of a deep vein thrombosis with a uterine myoma has been previously described [4,5], but few patients presented extensive thrombosis [6,7].…”