Effect of amniotic fluid on blood coagulation

Summary1. Infusions containing particulate matter, viz. whole amniotic fluid, amniotic fluid sediment, and glass beads, produce in dogs changes in both early and late phases of the clotting reaction. These changes are associated with the development of pulmonary hypertension.2. When dogs were given an active fibrinolysin followed by an infusion of whole amniotic fluid, the alterations in the clotting mechanism were either delayed or did not appear. No pulmonary hypertension developed in these animals.3. We infer that infusions containing particulate matter will produce in dogs both pulmonary hypertension and changes in the clotting mechanism. Although these are independent changes, both are as closely related to the damage to the pulmonary vessels as they are to the biological nature of the infusions.

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Amniotic fluid as a potent activator of blood coagulation and platelet aggregation: Study with rotational thromboelastometry

Thrombosis Research ◽

10.1016/j.thromres.2018.11.001 ◽

2018 ◽

Vol 172 ◽

pp. 142-149 ◽

Cited By ~ 2

Author(s):

Tomoaki Oda ◽

Naoaki Tamura ◽

Yi Shen ◽

Yukiko Kohmura-Kobayashi ◽

Naomi Furuta-Isomura ◽

...

Keyword(s):

Platelet Aggregation ◽

Amniotic Fluid ◽

Blood Coagulation ◽

Rotational Thromboelastometry

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Highly Procoagulant Extracellular Vesicles in Amniotic Fluid

Blood ◽

10.1182/blood.v128.22.4961.4961 ◽

2016 ◽

Vol 128 (22) ◽

pp. 4961-4961

Author(s):

Johannes Thaler ◽

Lena Hell ◽

Lukas Wisgrill ◽

Andreas Spittler ◽

Michael Schwameis ◽

...

Keyword(s):

Flow Cytometry ◽

Amniotic Fluid ◽

Blood Coagulation ◽

Extracellular Vesicles ◽

Whole Blood ◽

Blood Clotting ◽

Factor Xa ◽

Coagulation Cascade ◽

Contact Activation ◽

Plasma Factor

Abstract Background: The pathomechanisms underlying disseminated intravascular coagulation (DIC) following amniotic fluid (AF) embolism remain to be fully elucidated. Highly procoagulant phosphatidylserine (PS)- and tissue factor (TF) expressing extracellular vesicles (EVs) might play a central role. Objective: To perform extensive analyses of the procoagulant properties of AF with a panel of functional coagulation assays and flow cytometry to investigate the pathogenesis of AF induced DIC. Methods: A prothrombinase assay, an EV-TF dependent factor Xa (FXa) generation assay, a modified thrombin- and fibrin-generation assay, a whole blood clotting model and flow cytometry were applied in AF- and control plasma. Results: Phosphatidylserine expression was 21-fold increased in AF compared to plasma. Factor Xa generation was extremely high when TF-expressing EVs from AF were co-incubated with recombinant FVIIa. In the thrombin- and fibrin generation assay AF-derived EVs strongly activated the blood coagulation cascade via PS and TF. In a whole blood clotting model AF-derived TF-expressing EVs significantly shortened the clotting time from 734 ± 139 seconds in the presence- to 232 ± 139 seconds in the absence of an anti-TF antibody. The contact activation pathway via factor FXII was not affected. Applying flow cytometry, a sub-population of PS- and TF co-expressing EVs was clearly identified in AF. Conclusions: We thoroughly investigated the effect of AF on blood coagulation and found that PS+ and TF+ EVs determine its procoagulant potential. Taken together our data further delineate the pathomechanisms underlying AF-induced coagulopathy, which could improve diagnostic- and treatment modalities. Disclosures No relevant conflicts of interest to declare.

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Effect of Amniotic Fluid on Blood Coagulation

British Journal of Haematology ◽

10.1111/j.1365-2141.1972.tb05681.x ◽

1972 ◽

Vol 22 (3) ◽

pp. 353-355 ◽

Cited By ~ 28

Author(s):

L. D. Courtney ◽

M. Allington

Keyword(s):

Amniotic Fluid ◽

Blood Coagulation

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Amniotic fluid embolism

Fetal and Maternal Medicine Review ◽

10.1017/s096553959700003x ◽

1997 ◽

Vol 9 (1) ◽

pp. 35-47 ◽

Cited By ~ 3

Author(s):

Gary DV Hankins ◽

Steven Leigh Clark

Keyword(s):

Amniotic Fluid ◽

Blood Coagulation ◽

Fetal Heart ◽

Systemic Circulation ◽

In Utero ◽

Amniotic Fluid Embolism ◽

Squamous Cells ◽

Pathological Characteristics ◽

Clinical Onset

Attwood traces the earliest possible description of a case of amniotic fluid embolism (AFE) to 1825. The next case was described by Meyer some 101 years later. Not until 1941 was this obstetric catastrophe recognised as constituting a true syndrome with its own clinical and pathological characteristics. Any combination of sudden and profound shock, dyspnoea, cyanosis, apprehension, seizures, and the failure of rapid blood coagulation may herald the clinical onset of an AFE. Liban was the first to report the detection of squamous cells throughout the systemic circulation, an observation which was not explained at the time. Many have commented upon the ominous fetal heart pattern that almost invariably accompanies AFE if the fetus is in-utero at the time of the embolus.

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