Incidence of Vaginal Bleeding Before and After Cardiac Surgery With Cardiopulmonary Bypass

The aim of the present study was to evaluate the incidence of menstrual bleeding in women undergoing cardiac surgery with cardiopulmonary bypass.

This cross-sectional study recruited 200 women aged 11 years or older (post- menarche) who were scheduled electively for their first cardiac surgery (coronary artery bypass, valve, or congenital). The menstruation status of the patients before and after surgery was assessed. Additionally, the demographic and clinical parameters, as well as postoperative drainage and blood product transfusion, were compared between the patients with and without perioperative menstrual bleeding.

Five (2.5%) women had menstrual bleeding before surgery and 17 (8.5%) experienced vaginal bleeding after the operation. All of these 22 vaginal bleeding cases were self-limited, and there was no need for gynecological intervention. There were no statistically significant differences between the 22 women with vaginal bleeding and the 178 women without vaginal bleeding regarding background clinical variables, blood product transfusion, and postoperative drainage (380 ± 278 vs 500 ± 469 mL; P = 0.242).

Perioperative vaginal bleeding in women undergoing cardiac surgery is not uncommon. However, this finding is self-limited and does not increase postoperative drainage or blood product transfusion. (Iranian Heart Journal 2020; 21(2): 71-76)