Hemostasis in women with abnormal uterine bleedings and endometrial hyperplasia: 612.115:618.145‐007.61‐005.1

Abstract

Summary. Introduction. Abnormal uterine bleeding (AUB) is are the most common clinical symptom in women with endometrial hyperplasia (EН). The state of the local hemostasis in the endometrium is a significant factor in the development of endometrial pathology, including AUBs. However, there is a paucity of consensus regarding the alterations in the hemostatic balance in women with newly diagnosed and recurrent AUBs in EН. Aim: to identify the features of hemostasis indicators in women with AUBs and EН without atypia and to assess their diagnostic and pathogenetic significance. Materials and Methods. A prospective observational comparative parallel‐group study included a total of 93 women of reproductive age with AUBs and EН without atypia (main group) and 54 women with no menstrual and reproductive function disorders (control group). To evaluate the hemostasis, basic coagulation tests were conducted, along with assessments of fibrinolytic system indicators. Results. More pronounced hemostasis changes were found in women with recurrent AUBs compared with first‐time AUBs and EH, as well as in women with heavy menstrual bleeding (HMB) compared with intermenstrual uterine bleeding (IUB). In all women with AUBs and EH, elevated tissue plasminogen activator (t‐PA), urokinase plasminogen activator (u‐PA), D‐dimer level and reduced thrombin‐activated fibrinolysis inhibitor (TAFI) level were observed in the blood, and increased urokinase plasminogen activator receptor (u‐PAR) level in the endometrial tissue homogenate compared with the control. In women with recurrent AUBs, in comparison with the first‐time AUBs with EH, an increase in D‐dimer in the blood and an increase in u‐PAR in homogenate were observed. Conclusion. In women of reproductive age with AUBs and EH the nature of bleeding and its recurrence are accompanied by hemostasis changes at both central and peripheral levels.

For citation: Gasanova S.M., Kuzmenko G.N., Krasilnikova A.K., Popova I.G., Nazarov S.B. Hemostasis in women with abnormal uterine bleedings and endometrial hyperplasia. Tromboz, gemostaz i reologiya. 2024;(3):87–96. (In Russ.).]

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