Management of Gynecological Emergencies in Patients Using Warfarin: Retrospective Study in a Tertiary Center
Journal of Clinical Obstetrics and Gynecology, cilt.36, sa.1, ss.7-14, 2026 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 36 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.5336/jcog.2025-115586
- Dergi Adı: Journal of Clinical Obstetrics and Gynecology
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Central & Eastern European Academic Source (CEEAS), EMBASE, TR DİZİN (ULAKBİM), Academic Search Ultimate (EBSCO)
- Sayfa Sayıları: ss.7-14
- Anahtar Kelimeler: Emergencies, hemoperitoneum, uterine hemorrhage, warfarin
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: To evaluate gynecological emergencies in patients using warfarin and to discuss optimal management strategies. Material and Methods: This retrospective descriptive study included 20 patients receiving warfarin therapy with an international normalized ratio (INR) ≥2 who presented with gynecologic emergencies at a tertiary center between January 2017 and May 2023. Demographic data, indications for warfarin use, laboratory findings, interventions, transfusions, surgical procedures, length of hospital stay, and clinical outcomes were analyzed. Results: Patients were classified into 2 groups. Group 1 (n=10) included intra-abdominal hemorrhage cases, including ovarian cyst rupture, corpus luteum rupture, and postoperative bleeding. Group 2 (n=10) comprised patients with abnormal uterine bleeding (AUB). In Group 1, the mean age was 38.1±8.29 years, hemoglobin 6.69±1.36 g/dL, and INR 4.73±2.00. Conservative treatment was successful in 3 patients, whereas seven required surgery. In Group 2, the mean age was 39.8±9.67 years, hemoglobin 7.15±1.43 g/dL, and INR 3.42±1.84. Two patients underwent hysteroscopic procedures, and one required hysterectomy. Levonorgestrel-releasing intrauterine devices (LNG-IUD) were placed in seven patients. Conclusion: In this retrospective descriptive study, conservative management was often sufficient in hemodynamically stable patients, whereas surgery was required for uncontrolled bleeding. LNG-IUD were frequently used for AUB; however, the overall findings should be interpreted cautiously given the retrospective design, limited sample size, and absence of comparative analyses. Management of gynecological emergencies in patients receiving warfarin may benefit from an individualized, multidisciplinary approach.