Tests of coagulation and fibrinolysis were performed in 20 patients with severe preeclampsia and in 20 normal pregnant women. Compared with the normal patients, the women with severe pre-eclampsia had raised factor VIII, increased cryofibrinogen and reduced platelet counts. Despite increased resistance to urokinase-induced fibrinolysis, the pre-eclamptic women had lower plasminogen and increased serum and urinary F.D.P. levels. These results suggested that intravascular fibrin deposition was a feature of severe pre-eclampsia. In each test, the range of values in the pre-eclamptic women overlapped with the controls, so that no single test indicated whether intravascular coagulation was present in every case of severe pre-eclampsia. By the use of logistic analysis, it was possible to demonstrate that an abnormality of the coagulation and fibrinolytic systems was present in every case of severe pre-eclampsia. In 10 patients with moderate pre-eclampsia, the severity of the coagulation abnormality was intermediate between the severe cases and the controls.By sequential logistic analysis, it may be possible to anticipate the phase of clinical deterioration and permit delivery before the onset of fetal death. The haemostatic abnormalities would appear to be a constant and inevitable feature of pre-eclampsia.
The Extent of Diffuse Intravascular Coagulation and Fibrinolysis in Patients with Liver Cirrhosis
