Fibrinolysis in Obstetrical Coagulopathy

1961 ◽  
Vol 05 (01) ◽  
pp. 021-037 ◽  
Author(s):  
H Zilliacus
Keyword(s):  
Coagulation Factors ◽  
Clotting Factor ◽  
Foetal Death ◽  
Dilution Technique ◽  
Induced Labor ◽  
Blood Samples ◽  
Decidual Tissue ◽  
Obstetrics And Gynaecology ◽  
Obstetrical Management ◽  
Uterine Haemorrhage

SummaryIn the introduction it is stressed that in cases with normal blood coagulation and even in cases with a limited decrease of some of the coagulation factors, the contraction of the uterus after the passage of the placenta closes the vessel endings, thereby providing the conditions necessary for haemostasis through the clotting of the blood. In contrast to this, fibrinolytic uterine bleeding is a condition in which the clotting factor and clot are consumed despite adequate postpartum contraction of the uterus.The literature on obstetrical coagulopathies is briefly summarized.The incongruence in the clotting power of blood samples drawn simultaneously from a cubital vein and from the uterus in cases of severe uterine haemorrhage is pointed out.With the aid of a plasma-dilution technique (Schneider) for the estimation of fibrinogen and fibrinolysis it was shown that in 6 out of 8 investigated cases of premature separation of the placenta, in 4 out of 5 observed cases of longstanding intrauterine foetal death and in 2 cases of pitocin drip induced labor considerable fibrinolytic activity was present in the blood from the uterus, whereas only slight activity if any, could be observed in blood samples drawn simultaneously from a cubital vein. These observations are found to be in conformity with the finding of considerable amounts of fibrinolytic activators in myométrial, placental and decidual tissue reported by other authors.Figures for obstetrical cases (19,808 deliveries) and uterine haemorrhage during the 5-year period 1955—1959 at the 1st Department of Obstetrics and Gynaecology, University Central Hospital, Helsinki, Finland, are presented. The main principles of obstetrical management at this hospital are outlined, with special reference to uterine coagulopathic haemorrhage.

scholarly journals Multidisciplinary Unit Improves Pregnancy Outcomes in Women with Rheumatic Diseases and Hereditary Thrombophilias: An Observational Study

2021 ◽  
Vol 10 (7) ◽  
pp. 1487
Author(s):  
Isabel Añón-Oñate ◽  
Rafael Cáliz-Cáliz ◽  
Carmen Rosa-Garrido ◽  
María José Pérez-Galán ◽  
Susana Quirosa-Flores ◽  
...  
Keyword(s):  
High Risk ◽  
Observational Study ◽  
Medical Care ◽  
Pregnant Women ◽  
Rheumatic Diseases ◽  
Absolute Risk ◽  
University Hospital ◽  
Obstetric Outcomes ◽  
Number Needed To Treat ◽  
Foetal Death

Rheumatic diseases (RD) and hereditary thrombophilias (HT) can be associated with high-risk pregnancies. This study describes obstetric outcomes after receiving medical care at a multidisciplinary consultation (MC) and compares adverse neonatal outcomes (ANOs) before and after medical care at an MC. This study is a retrospective observational study among pregnant women with RD and HT treated at an MC of a university hospital (southern Spain) from 2012 to 2018. Absolute risk reduction (ARR) and number needed to treat (NNT) were calculated. A total of 198 pregnancies were registered in 143 women (112 with RD, 31 with HT), with 191 (96.5%) pregnancies without ANOs and seven (3.5%) pregnancies with some ANOs (five miscarriages and two foetal deaths). Results previous to the MC showed 60.8% of women had more than one miscarriage, with 4.2% experiencing foetal death. MC reduced the ANO rate by AAR = 60.1% (95%CI: 51.6−68.7%). The NNT to avoid one miscarriage was 1.74 (95%CI: 1.5–2.1) and to avoid one foetal death NNT = 35.75 (95CI%: 15.2–90.9). A total of 84.8% of newborns and 93.2% of women did not experience any complication. As a conclusion, the follow-up of RD or HT pregnant women in the MC drastically reduced the risk of ANOs in this population with a previous high risk.

scholarly journals Anti-epileptic drug exposure and risk of foetal death in utero

2017 ◽  
Vol 137 (1) ◽  
pp. 20-23 ◽  
Author(s):  
F. J. E. Vajda ◽  
T. J. O'Brien ◽  
J. Graham ◽  
A. A. Hitchcock ◽  
C. M. Lander ◽  
...  
Keyword(s):  
Drug Exposure ◽  
In Utero ◽  
Foetal Death ◽  
Anti Epileptic Drug

scholarly journals Comparison of vaginal and oral misoprostol, for the induction of labour in women with intra-uterine foetal death

2017 ◽  
Vol 6 (7) ◽  
pp. 2900
Author(s):  
Kala K. ◽  
Anupama V. Rani ◽  
Dharmavijaya M. N. ◽  
Umashankar K. M.
Keyword(s):  
Prostaglandin E1 ◽  
Post Partum ◽  
Induction Of Labour ◽  
Delivery Time ◽  
Foetal Death ◽  
Tertiary Institution ◽  
Oral Misoprostol ◽  
Significant Difference ◽  
Successful Induction ◽  
Vaginal Misoprostol

Background: Misoprostol is a prostaglandin E1 analogue, a methyl-ester of prostaglandin E1 additionally methylated at C-16. Misoprostol is an effective myometrial stimulant of pregnant uterus, selectively binding to prostanoid receptors. The objective of the study was to compare the efficacy of vaginal and oral misoprostol for the induction of labour in women with intra-uterine foetal death (IUFD).Methods: A prospective randomised clinical trial, comparing 50µg oral and 50µg vaginal misoprostol, six hourlies for a maximum of four doses for the induction of labour in women with IUFD. All patients with IUFD after 28 weeks without previous uterine surgeries, without contraindications for prostaglandins are included in the study. The study was conducted in the Department of Obstetrics and Gynecology MVJ Medical College and Research Hospital, Hoskote. Bangalore from June 2012 to June 2015. It is a tertiary institution serving predominantly rural population. The primary outcome measure was the induction to delivery time, secondary all complications were noted.Results: Twenty-five women were randomised to the vaginal route and twenty-five to the oral route. The induction to delivery time was longer with vaginal misoprostol 10.5±4.03 compared to oral misoprostol (9.58±4.9). There was no significant difference in the amount of misoprostol needed to achieve successful induction in the two groups. 3 patients needed oxytocin augmentation to complete the induction of labour. There were no cases of failed induction. The systemic side effects (shivering, diarrhoea, vomiting and pyrexia) were more common with oral misoprostol (44.5%) compared to vaginal misoprostol (20%).Conclusions: Oral misoprostol achieved successful induction of labour in women with IUFD in a shorter time than vaginal misoprostol. Both routes are equally effective in termination of pregnancy. Sublingual route is easy to administer, patient compliant, no need for internal examination, less chance of labour dysfunction, less chance of post-partum sepsis.

Neglected shoulder presentation with foetal death managed by internal podalic version with nitroglycerine and sevoflurane

2016 ◽  
Vol 37 (1) ◽  
pp. 111-112
Author(s):  
Tomoyuki Sasano ◽  
Takuji Tomimatsu ◽  
Takeshi Kanagawa ◽  
Tadashi Kimura
Keyword(s):  
Foetal Death

scholarly journals Evaluation of clinicopathological profile of subjects with intrauterine fetal death

2018 ◽  
Vol 7 (5) ◽  
pp. 1742
Author(s):  
Sunil Kumar Pandey ◽  
Surabhi Porwal
Keyword(s):  
Prospective Observational Study ◽  
Fetal Death ◽  
Intrauterine Fetal Death ◽  
Fibrinoid Necrosis ◽  
Foetal Death ◽  
Laboratory Findings ◽  
Medical College ◽  
Obstetrics And Gynaecology ◽  
Clinicopathological Profile ◽  
Laboratory Profile

Background: Intrauterine foetal death is an immense emotional burden for everyone concerned specially in the last trimester. Therefore, it is very important to find out, what has happened. Evaluation of clinical and pathological profile of women presenting with intrauterine foetal death has evoked great interest among the obstetricians.Methods: The prospective observational study was conducted in the department of Obstetrics and Gynaecology N.S.C.B. Medical College Jabalpur during 1st June 2012 to 31st October 2013. A total of 155 intrauterine foetal death subjects admitted during this period were evaluated. Clinically and laboratory profile of subjects done.  Histomorphology of placenta was performed in each case. Full HPR finding were then correlated with clinical and laboratory findings of subjects.  Results: Poor vascularity of villi and fever were significantly associated (p<0.01). Hypertension and Convulsion and fibrinoid necrosis, syncytial knot and placental infarcts were significantly associated (p<0.001) Premature placenta is associated with cytotrophoblastic layer (p<0.01). Conversely post mature placenta is associated with calcification and infarction.  (p<0.01).  Conclusions: All placentae associated with foetal death have either gross or microscopic abnormalities. Present study is a step towards understanding and extrapolating the already known causes of intrauterine foetal death in the perspective of Jabalpur and its adjoining districts.

scholarly journals Conservative management of single foetal death in multiple pregnancy at a tertiary care hospital in Bangladesh: Two case reports

2017 ◽  
Vol 45 (3) ◽  
pp. 172-174
Author(s):  
Eva Rani Nandi ◽  
Fatema Ashraf ◽  
Nilofar Yasmin ◽  
Hasina Begum
Keyword(s):  
Case Reports ◽  
Tertiary Care ◽  
Multiple Pregnancy ◽  
Care Hospital ◽  
Foetal Death ◽  
Mortality And Morbidity ◽  
Risk Of Mortality ◽  
Proper Diagnosis ◽  
Management Challenge

The single fetal death in multiple pregnancy is not rare. Death of one fetus in multiple pregnancy increases the risk of mortality and morbidity of the surviving fetus. This might pose management challenge to the obstetrician. It is a cause of great concern and psychological stress to the parents. Proper diagnosis and intervention in appropriate time can improve the maternal and neonatal outcome. Adequate counseling, psychological support and close follow up are mandatory. There are potential complications to the mother and the surviving twin.Bangladesh Med J. 2016 Sep; 45 (3): 172-174

The effects of an antiserum to the contractile proteins of the heart on the developing rat embryo

Development ◽  
1971 ◽  
Vol 25 (2) ◽  
pp. 203-212
Author(s):  
Colin L. Berry
Keyword(s):  
Rat Heart ◽  
Contractile Proteins ◽  
Degenerative Changes ◽  
Foetal Death ◽  
Rat Embryo ◽  
Electron Microscopic ◽  
Microscopic Studies ◽  
Specific Reactivity ◽  
Developing Rat ◽  
Isolated Rat

An antiserum with specific reactivity against the contractile proteins of the rat heart has been raised in the rabbit. Fractions of the serum have been shown to enter the isolated rat embryo by electron-microscopic studies with ferritin, where they bind to the myocardium, producing degenerative changes. Both IgG and IgM fractions are toxic, producing foetal death in a large proportion of explanted embryos.

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