Should You Stop Anticoagulants Before Gynecological Surgery?

Should anticoagulants be discontinued before gynecological surgery?

Hello Director Cao,
I would like to ask you a question.
In the past few days, I am considering undergoing a dilation and curettage (D&C) procedure in the obstetrics and gynecology department.
I usually take aspirin; should I stop taking it a few days before the surgery? (My coagulation function is normal.) If you have time, could you please help clarify my doubts? (The clinic I visit is closed as the staff is on a trip.) I really appreciate your assistance! Wishing you a smooth workday and a happy Mid-Autumn Festival!
Best regards,
Nicole

Nicole, 50~59 year old female. Ask Date: 2018/09/22

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is generally recommended to take a break for 2 to 3 days.
Wishing you good health.

Reply Date: 2018/09/22

More Info

When considering whether to stop anticoagulants before undergoing gynecological surgery, such as a dilation and curettage (D&C), it is essential to weigh the risks of bleeding against the risks of thrombosis (blood clots). In your case, since you are taking aspirin, which is an antiplatelet medication rather than a traditional anticoagulant, the approach may differ slightly.

Aspirin works by inhibiting platelet aggregation, which can increase the risk of bleeding during and after surgical procedures. However, the decision to continue or discontinue aspirin should be made based on several factors, including the type of surgery, your overall health, and your history of clotting or bleeding disorders.

1. Consultation with Your Healthcare Provider: The most crucial step is to consult with your gynecologist or the surgeon performing the procedure. They will have the best understanding of your specific situation and can provide personalized advice. If your doctor is unavailable, consider reaching out to another healthcare provider or a pharmacist for guidance.

2. Timing of Discontinuation: If your doctor advises you to stop taking aspirin, they will likely recommend a specific timeframe. Generally, it is suggested to stop aspirin at least 5 to 7 days before surgery to allow your platelets to recover and reduce the risk of excessive bleeding. However, this can vary based on individual circumstances.

3. Risks of Stopping Aspirin: If you have a history of cardiovascular issues or other conditions that put you at risk for blood clots, stopping aspirin may not be advisable. Your doctor will need to assess your risk factors and may suggest alternative strategies, such as bridging therapy with other medications.

4. Monitoring and Follow-Up: If you decide to stop taking aspirin, monitor for any signs of increased clotting risk, such as swelling, pain, or redness in your legs, or any other unusual symptoms. It is essential to communicate any concerns with your healthcare provider.

5. Postoperative Care: After the surgery, your doctor will provide guidance on when to resume aspirin. This is typically based on your recovery and the risk of bleeding. It is crucial to follow their instructions closely to ensure a safe recovery.

In summary, while it is generally advisable to stop aspirin before gynecological surgery to minimize bleeding risks, the decision should be made in consultation with your healthcare provider, considering your individual health profile and the specifics of the surgery. Always prioritize open communication with your medical team to ensure the best outcomes for your health and safety.

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