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Management considerations for patients with uterine fibroids and concurrent venous thromboembolism

Moulder, Janelle K.; Siedhoff, Matthew T.; Till, Sara R.; Moll, Stephan

Current Opinion in Obstetrics and Gynecology: August 2016 - Volume 28 - Issue 4 - p 329–335
doi: 10.1097/GCO.0000000000000286
MINIMALLY INVASIVE GYNECOLOGIC PROCEDURES: Edited by Matthew T. Siedhoff
Editor's Choice

Purpose of review The purpose is to provide an update on management strategies for uterine fibroids in the setting of venous thromboembolism (VTE).

Recent findings Uterine fibroids and VTE are independently associated with morbidity and increasing healthcare costs. Women with large uterine fibroids have a higher likelihood of VTE. Current strategies for stratifying patients with VTE take into account the nature of the VTE (i.e., truly provoked or unprovoked) and many patients may only require short-term anticoagulation. In those patients with risk factors for recurrent VTE, longer term anticoagulation may be required.

Summary In women with large uterine fibroids, the likelihood of concurrent VTE increases. Peri and postoperative management should be determined based on patient-specific risk stratification, with the majority of patients requiring short-term anticoagulation. Further risk stratification may be required for patients with essentially an unprovoked VTE, and consultation with a thrombosis specialist is recommended.

aDepartment of Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery, University of North Carolina, Chapel Hill, North Carolina

bDepartment of Obstetrics and Gynecology, Cedars Sinai Medical Center, Los Angeles, California

cDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan

dDepartment of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA

Correspondence to Janelle K. Moulder, MD, Department of Obstetrics and Gynecology, Minimally Invasive Gynecologic Surgery, University of North Carolina, 4010 Old Clinic Building Campus Box 7570, Chapel Hill, NC 27599-7570, USA. Tel: +1 984 215 3050; e-mail: janelle_moulder@med.unc.edu

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