fibrin and Abruptio-Placentae

Topics: Abruptio Placentae; Blood Coagulation; Blood Coagulation Disorders; Blood Coagulation Factors; Blood Coagulation Tests; Blood Platelet Disorders; Blood Transfusion; Disseminated Intravascular Coagulation; Embolism, Amniotic Fluid; Factor XIII Deficiency; Female; Fetal Death; Fetal Diseases; Fibrin; Fibrinogen; Fibrinolysis; Hemophilia A; Humans; Liver Diseases; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Hematologic; Sepsis; Uterine Hemorrhage; Vitamin K

Topics: Abruptio Placentae; Animals; Blood Platelets; Disseminated Intravascular Coagulation; Female; Fibrin; Fibrinolysis; Heat Exhaustion; Hemolytic-Uremic Syndrome; Heparin; Humans; Polymers; Pregnancy; Shock

Topics: Abruptio Placentae; Adrenal Glands; Aminocaproates; Animals; Basement Membrane; Biopsy; Blood Coagulation Disorders; Blood Coagulation Factors; Blood Platelets; Brain; Female; Fibrin; Fibrinogen; Fibrinolysis; Fluorescent Antibody Technique; Hemorrhage; Hemorrhagic Disorders; Heparin; Humans; Hypertension, Malignant; Kidney Cortex Necrosis; Kidney Failure, Chronic; Kidney Glomerulus; Liver; Maternal Mortality; Microscopy, Electron; Myocardium; Placental Extracts; Pre-Eclampsia; Pregnancy; Rabbits; Shwartzman Phenomenon; Thromboplastin; Thrombosis

Topics: Abruptio Placentae; Amniotic Fluid; Embolism, Air; Embolism, Fat; Female; Fetal Death; Fibrin; Humans; Inhalation; Pregnancy; Pregnancy Complications, Cardiovascular; Pulmonary Circulation; Pulmonary Embolism; Pulmonary Heart Disease; Thrombophlebitis

Recent evidence has linked preterm premature rupture of the fetal membranes (PPROM) to placental abruption. Because neutrophils are a rich source of proteases that can degrade extracellular matrix in abruption-associated PPROM, we examined whether decidual neutrophil infiltration complicates abruption-associated PPROM. Accordingly, immunostaining for the neutrophil marker CD15 was performed in placentas obtained after overt abruption (decidual hemorrhage) with or without PPROM and in control placentas. Abruptions were associated with a marked decidual neutrophil infiltration that peaked after PPROM, whereas decidua from gestational age-matched controls were virtually devoid of neutrophils. Neutrophil infiltrates co-localized with fibrin deposition. Because abruptions elicit intense decidua-enhanced thrombin production, we examined the regulation of abruption-induced neutrophil infiltration. Expression of the primary neutrophil chemoattractant interleukin-8 (IL-8) was evaluated in leukocyte-free term decidual cells incubated with estradiol (E2; control) or with E2+medroxyprogesterone acetate (to mimic pregnancy)+/-thrombin. After 24 hours, enzyme-linked immunosorbent assay measurements indicated that thrombin (0.1 to 2.5 U/ml) elicited a dose-dependent elevation in secreted IL-8 (P<0.05) with 2.5 U/ml of thrombin increasing IL-8 levels by >14-fold in E2 and E2+medroxyprogesterone incubations. Results were validated by Western blot and quantitative reverse transcriptase-polymerase chain reaction. In summary, thrombin-enhanced IL-8 expression in term decidual cells may explain how abruption-associated PPROM promotes decidual neutrophil infiltration.

Topics: Abruptio Placentae; Adult; Blotting, Western; Cells, Cultured; Decidua; Enzyme-Linked Immunosorbent Assay; Estradiol; Female; Fetal Membranes, Premature Rupture; Fibrin; Humans; Immunohistochemistry; Interleukin-8; Lewis X Antigen; Medroxyprogesterone Acetate; Neutrophil Infiltration; Neutrophils; Pregnancy; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Thrombin

This investigation was undertaken to determine the relationship, if any, between peripheral placental separation and idiopathic premature labor. Ninety placentas from prematurely delivered patients (who had had no antepartum bleeding) were examined grossly and microscopically. Criteria for antepartum peripheral placental separation included adherent clot, with fibrin deposition and lamination, as well as polymorphonuclear infiltration and marginal decidual necrosis. Forty-nine placentas showed unequivocal evidence of previous peripheral separation. Another three placentas showed presumptive evidence of previous peripheral separation. It is suggested that this separation is of venous origin, and that it may play a role in the process of premature labor. This is not necessarily a cause and effect relationship.

Topics: Abruptio Placentae; Decidua; Female; Fibrin; Hemorrhage; Humans; Obstetric Labor, Premature; Placenta; Placenta Diseases; Pregnancy

Topics: Abruptio Placentae; Calcinosis; Female; Fibrin; Hemangioma; Humans; Hydatidiform Mole; Infarction; Placenta; Placenta Diseases; Pregnancy; Thrombosis; Ultrasonography; Uterine Neoplasms

Highly purified fibrinogen-fibrin related antigen (FR-antigen) was isolated with good recovery from 1.0--2.0 ml of human plasma, by immuno-affinity chromatography with antibody specific for fibrinogen and fibrin, and plasmin degradation products X, Y, D and D-D dimer. In FR-antigen from defibrinating patients there was evidence for thrombin activity alone (mainly disseminated cancer) or both plasmin and thrombin (mainly abruptio placentae). Thus, the molar ratio of N-terminal Gly-Tyr in the FR-antigen of 18 of 20 patients strongly suggested thrombin activity (95th percentile). In addition, sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) on unreduced samples frequently showed bands similar in mol wt to fragments X, Y and D, and in the reduced samples A alpha and B beta chain degradation, both indicating plasmin activity. 'N-terminal beta chain Ala' was elevated in the antigen of four of 20 patients, also suggesting plasmin activity (99th percentile). Combined thrombin, plasmin and factor-XIII activity, as shown with high levels of serum FR-antigen (greater than 10 mg/dl). In some defibrinating patients, especially those with disseminated cancer, heterogeneity of unreduced FR-antigen and A alpha chain degradation, both indicators of mild plasmin-like activity which are commonly seen in normals, were absent.

Topics: Abruptio Placentae; Amino Acids; Antigens; Chromatography, Affinity; Electrophoresis, Polyacrylamide Gel; Female; Fibrin; Fibrin Fibrinogen Degradation Products; Fibrinogen; Fibrinolysis; Humans; Male; Neoplasms; Pregnancy

The maternal coagulation mechanism has been investigated in an effort to identify its role, if any, in the pathogenesis of eclampsia. Thrombocytopenia was identified in 28 of 95 cases (29 per cent), a prolonged thrombin time in 19 of 38 (50 per cent), abnormally elevated serum fibrinogen-fibrin degradation products in two of 65 (3 per cent), and circulating fibrin monomer in one out of 20 (5 per cent). Overt hemolysis was rare (2 per cent). Thus the pattern as well as the degree of change in the maternal coagulation mechanism differed remarkably from that typical of severe abruptio placentae and of prolonged retention of a dead fetus, the classic obstetric models of fast and slow disseminated intravascular coagulation. It is concluded that the coagulation changes when present in eclampsia are effect rather than cause. Moreover, the changes may evolve primarily from platelet adherence at sites of vascular endothelial damage as the consequence of segmental vasospasm and vasodilatation rather than be triggered by the escape of thromboplastin from the placenta into the maternal circulation.

Topics: Abruptio Placentae; Adolescent; Blood Cell Count; Blood Platelets; Disseminated Intravascular Coagulation; Eclampsia; Female; Fibrin; Fibrin Fibrinogen Degradation Products; Fibrinogen; Hemolysis; Humans; Pregnancy; Thrombin; Thrombocytopenia; Time Factors

Soluble fibrin monomer complexes have been determined in approximately 500 obstetric patients by protamine sulfate precipitation, as a test for intravascular coagulation. The incidence of positive fibrin monomer was less than 1% in 139 samples drawn during normal pregnancy. In confirmed abruptio placentae, 84% of samples were positive, but other sources of antepartum bleeding were negative. Positive results were obtained in 24% of samples from patients between 3 and 48 hours after injection of hypertonic saline for second trimester abortion, 33% were positive by only 3% were positive after administration of prostaglandins. The test for intravascular coagulation is simple and rapidly carried out. The results correlated well with the clinical condition of patients with disseminated intravascular coagulation. However, the test is usually negative in patients with thromboembolic phenomena.

Topics: Abruptio Placentae; Blood Coagulation Tests; Disseminated Intravascular Coagulation; Female; Fetal Death; Fibrin; Fibrinogen; Humans; Pregnancy; Pregnancy Complications; Pregnancy Complications, Hematologic; Pregnancy Trimester, First; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Prostaglandins; Protamines; Thromboembolism

Discrimination between the physiological cleavage fragments of fibrinogen and fibrin offers an approach to differentiation between fibrinogenolytic processes and fibrinolysis after coagulation. By use of the cleavage-associated neoantigen of fibrinogen (fg-D(neo)) as a molecular marker, characteristic differences between the D regions of fibrinogen derivatives and fibrin derivatives can be demonstrated. The expression of fg-D(neo) by X, Y, D:E complex, and D-fragments of fibrinogen or fibrin is shown to be quantitative and unitary. Characteristic differences between fg-D(neo) sites present on fibrinogen cleavage fragments, as contrasted to fibrin cleavage fragments, are indicated by different competitive inhibition slopes, and appear to reflect differential binding affinity of selected anti-fg-D(neo) antibodies for the specific molecular site. There is a linear relationship between the slope of quantitative competitive inhibition and the relative molar ratio of fibrinogen and fibrin derivatives. Identical immunochemical expressions are observed in vitro and in vivo, and support the thesis that cleavage in vivo is produced by plasmin. The differential immunochemical features of fg-D(neo) expression may be the result of stable conformational and/or subtle structural differences between the D region of fibrinogen and fibrin cleavage fragments and suggest that precise changes in the D region are associated with the fibrin transition. These molecular features not only provide additional insight into the molecular immunology and structure of fibrinogen, but also appear to offer a new molecular approach to discrimination between fibrinogenolytic mechanisms as contrasted to fibrinolysis secondary to coagulation.

Topics: Abruptio Placentae; Acute Kidney Injury; Adenocarcinoma; Binding Sites, Antibody; Binding, Competitive; Blood Coagulation Disorders; Epitopes; Female; Fibrin; Fibrinogen; Fibrinolysin; Fibrinolysis; Humans; Immune Sera; Iodine Isotopes; Male; Melanoma; Meningococcal Infections; Peritonitis; Pregnancy; Prostatic Neoplasms; Radioimmunoassay; Structure-Activity Relationship

Topics: Abruptio Placentae; Acute Kidney Injury; Animals; Anuria; Disseminated Intravascular Coagulation; Female; Fibrin; Iodine Radioisotopes; Kidney; Kidney Glomerulus; Mercury Poisoning; Methemoglobin; Pregnancy; Rabbits; Shock; Shwartzman Phenomenon; Tourniquets

Topics: Abortion, Missed; Abruptio Placentae; Blood Coagulation Tests; Collagen Diseases; Erythrocytes; Esters; Female; Fibrin; Fibrinolysis; Fluorides; Hemagglutination Inhibition Tests; Humans; Kidney Diseases; Latex Fixation Tests; Leukemia; Ovarian Neoplasms; Pre-Eclampsia; Pregnancy; Pyruvates; Shock; Staphylococcus; Uterine Neoplasms

Topics: Abruptio Placentae; Antigens; Blood Coagulation; Female; Fibrin; Fibrinogen; Fibrinolysin; Fibrinolysis; Humans; Liver Cirrhosis; Neoplasms; Pregnancy

Topics: Abruptio Placentae; Adolescent; Adult; Arteries; Blood Coagulation Tests; Cesarean Section; Delivery, Obstetric; Female; Fetal Death; Fibrin; Fibrinogen; Fibrinolysis; Humans; Pregnancy; Uterus; Veins

Topics: Abruptio Placentae; Animals; Blood Coagulation; Blood Coagulation Disorders; Female; Fibrin; Fibrinogen; Fibrinolysin; Humans; Infant, Newborn; Infant, Newborn, Diseases; Pregnancy; Pregnancy Complications, Hematologic; Rabbits

Topics: Abruptio Placentae; Animals; Cardiac Output; Disease Models, Animal; Dye Dilution Technique; Embolism, Amniotic Fluid; Female; Fibrin; Humans; Latex; Male; Meconium; Methods; Microspheres; Placenta; Pregnancy; Rabbits; Radioisotopes; Retinal Vessels; Thrombin; Thromboplastin; Time Factors; Tissue Extracts; Xenon

Topics: Abruptio Placentae; Aminocaproates; Animals; Aprotinin; Blood Coagulation Disorders; Blood Transfusion, Intrauterine; Delivery, Obstetric; Extraembryonic Membranes; Female; Fetus; Fibrin; Fibrinogen; Fibrinolysis; Humans; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications, Hematologic; Rabbits; Uterine Diseases; Uterus

The levels of fibrin, fibrinogen degradation products (F.D.P.) in the serum were investigated in normal pregnancy and parturition, after caesarean section, and in patients with abruptio placentae, eclampsia, intrauterine death, and post-partum haemorrhage. No significant change occurred during normal pregnancy, but a highly significant increase was found during labour and again during the first week after normal delivery. After caesarean section the levels of F.D.P. were increased two to four hours after operation, and substantially higher levels were found three to eight days after operation than after normal delivery. High levels of F.D.P. were associated with abruptio placentae and eclampsia, and increased levels after intrauterine death and post-partum haemorrhage.An excess of F.D.P. with diminished or normal systemic fibrinolytic activity suggests that local intravascular fibrin deposition and fibrinolysis occur in normal parturition and in these complications of pregnancy. The very high levels of F.D.P. found in abruptio placentae will be important in the pathogenesis of the defective haemostasis that may accompany this complication.

Topics: Abruptio Placentae; Cesarean Section; Eclampsia; Female; Fetal Death; Fibrin; Fibrinogen; Fibrinolysis; Hemostasis; Humans; Labor, Obstetric; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications

Topics: Abortion, Septic; Abruptio Placentae; Antibodies; Antigens; Blood Coagulation Disorders; Eclampsia; Embolism, Amniotic Fluid; Female; Fetal Death; Fibrin; Fibrinogen; Fibrinolysis; Hemostasis; Humans; Immunoelectrophoresis; Kidney Glomerulus; Lung; Pregnancy; Pregnancy Complications, Hematologic; Spleen; Thrombelastography

Topics: Abruptio Placentae; Adult; Animals; Anuria; Bilirubin; Blood Coagulation Disorders; Dogs; Erythrocytes; Female; Fibrin; Fibrinolysis; Hematologic Diseases; Hemolysis; Humans; Mice; Pregnancy; Rabbits; Rats; Shock, Hemorrhagic; Thrombin; Thromboplastin

Topics: Abruptio Placentae; Animals; Blood Coagulation Disorders; Dogs; Embolism, Amniotic Fluid; Female; Fibrin; Humans; Meconium; Mice; Motion Pictures; Photomicrography; Pregnancy; Pulmonary Embolism; Rabbits; Staining and Labeling

Topics: Abruptio Placentae; Clinical Laboratory Techniques; Coagulants; Deoxyribonuclease I; Female; Fibrin; Fibrinogen; Fibrinolysin; Hemostatics; Humans; Latex Fixation Tests; Microspheres; Pregnancy; Streptodornase and Streptokinase; Streptokinase

Topics: Abruptio Placentae; Decidua; Female; Fibrin; Humans; Infarction; Pregnancy; Thrombosis

Topics: Abruptio Placentae; Female; Fibrin; Fibrinolysis; Hemorrhage; Humans; Pregnancy; Pregnancy Complications

Topics: Abortion, Criminal; Abortion, Induced; Abortion, Spontaneous; Abruptio Placentae; Afibrinogenemia; Blood Coagulation; Criminals; Female; Fibrin; Humans; Placenta; Pregnancy

Topics: Abruptio Placentae; Female; Fibrin; Humans; Placenta; Pregnancy; Shigella dysenteriae

Topics: Abruptio Placentae; Female; Fibrin; Hemorrhage; Humans; Placenta; Pregnancy; Stroke; Uterine Hemorrhage; Uterus

Topics: Abruptio Placentae; Female; Fibrin; Kidney Tubular Necrosis, Acute; Nephrons; Placenta; Pregnancy