PARAMETERS OF FIBRINOLYSIS IN PERITONEAL-FLUID AND PLASMA IN DIFFERENT STAGES OF THE MENSTRUAL-CYCLE

The purpose of this study was to investigate differences in fibrinolyt ic activity in peritoneal fluid and plasma of women in the first and s econd part of the menstrual cycle. Given the classic concept of decrea sed fibrinolytic activity as a cause of adhesion formation, and if suc h differences are found, the stage of women's menstrual cycle should b e taken into consideration when scheduling a laparotomy. We measured f ibrinolytic parameters in peritoneal fluid and plasma in eight women i n the pre-ovulatory period and in eleven women in the post-ovulatory p eriod of the menstrual cycle. There were no differences in t-PA-Ag, t- PA-Act, u-PA-Ag and scu-PA concentrations in peritoneal fluid between the pre-and post-ovulatory group. Nevertheless, PAI-1-Ag in peritoneal fluid was three-fold higher in the post-ovulatory phase (p < 0.02). I n peritoneal fluid the concentrations of both TDP and FbDP were three- fold higher at the same phase (p less-than-or-equal-to 0.05). Plasma u -PA-Ag and scu-PA concentrations were significantly lower (30%, p < 0. 05) in the post-ovulatory phase and also lower than plasma u-PA-Ag and scu-PA (measured with the same assay) in a group of 50 healthy indivi duals. No differences in t-PA and PAI concentration were found. In con clusion, the intraperitoneal fibrinolytic capacity might be impaired i n the second part of the menstrual cycle, regarding the elevated level s of PAI-1-Ag, leading to an increased risk for post-ovulatory adhesio n formation. The low plasma u-PA-Ag and scu-PA levels post-ovulatory m ay have clinical relevance.