fibrin and Postpartum-Hemorrhage

Topics: Acute Disease; Animals; Blood Coagulation Disorders; Blood Coagulation Factors; Blood Coagulation Tests; Disseminated Intravascular Coagulation; Embolism, Amniotic Fluid; Female; Fetal Death; Fibrin; Fibrinogen; Fibrinolysis; Hemoglobinometry; Humans; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications, Hematologic; Puerperal Disorders; Shock, Septic; Thrombin

This prospective, observational study investigated the utility of Fibtem A5 and Clauss fibrinogen as predictors of progression of postpartum hemorrhage (PPH). A consecutive cohort of 356 women experiencing 1000 to 1500 mL PPH was recruited. Fibtem and fibrinogen were measured and subsequent transfusions, invasive procedures, and bleed volume recorded. Women progressing to 8 U blood products (red blood cells [RBCs] + fresh frozen plasma [FFP] + platelets) had a median (interquartile range) fibrinogen and Fibtem A5 of 2.1 (1.8-3.4) g/L and 12 (7-17) mm, respectively, compared with 3.9 (3.2-4.5) and 19 (17-23) for those not progressing. On multivariate analysis, Fibtem was an independent predictor for progression to bleeds >2500 mL (95% confidence interval [CI], 0.85 [0.77-0.95]). Receiver operating characteristic area under the curve (95% CI) for progression to RBC transfusion was 0.67 (0.60-0.74) for fibrinogen and 0.61 (0.54-0.68) for Fibtem, and progression to >2500 mL was 0.71 (0.61-0.81) and 0.75 (0.66-0.85) for fibrinogen and Fibtem, respectively. Fibtem A5 <10 mm was associated with more prolonged bleeds (median [95% CI], 127 [44-210] compared with 65 [59-71] minutes; P = .018) and longer stay in the high-dependency unit (23.5 [18.4-28.5] compared with 10.8 [9.7-11.8] hours). Fibtem is a rapidly available early biomarker for progression of PPH.

Topics: Adult; Biomarkers; Blood Coagulation; Erythrocyte Transfusion; Female; Fibrin; Humans; Postpartum Hemorrhage

Topics: Blood Coagulation; Erythrocyte Transfusion; Female; Fibrin; Humans; Postpartum Hemorrhage

Topics: Adult; Female; Fibrin; Humans; Hysterectomy; Placenta Accreta; Postpartum Hemorrhage; Pregnancy; Recurrence; Reoperation; Uterine Inertia

30 women were examined to determine the hemostasis during the legally induced abortion. The blood coagulated in the intervillous spaces while the fetus is removed. Immediately after the termination of the curettment the nidation area is covered by filaments of fibrin and incorporated erythrocytes. More frequent as post partum platelet thrombi occur especially in the area of decidua parietalis. The intravascular findings are similar to post partum changes after the removal of the placenta. Obstruction clots of the spiral arterioles contain fibrin deposits, pletelet thrombi and erythrocytes (mixed form of thrombi). Residual decidua and trophoblast cells are seldom involved in the obturation of the vessels. The traumatic damages of the uterine wall are described (extravascular fibrin deposits, interstitial bleeding, succulent tissue a.s.o.).. Hemostasis was studied in 30 women during legal abortion. The blood coagulated in the intervillous spaces while the fetus is removed. Immed iately after the termination of the curettage the nidation area is covered by filaments of fibrin and incorporated erythrocytes. Platelet thrombi occur especially in the area of decidua parietalis, more frequently than in the postpartum. The intravascular findings are similar to postpartum changes after the removal of the placenta. Obstru ction clots of the spiral arterioles contain fibrin deposits, platelet thrombi and erythrocytes (mixed form of thrombi). Residual decidua and throphoblast cells are seldom involved in the obturation of the vessels. The traumatic damages of the uterine wall are described (extra vascular fibrin deposits, interstitial bleeding, succulent tissue a.s.o.). The local hemostatic differences are closely related to the changes and reactions of the endometrium in early pregnancy.

Topics: Abortion, Legal; Adult; Biopsy; Blood Platelets; Female; Fibrin; Hemostasis; Humans; Placenta; Postpartum Hemorrhage; Postpartum Period; Pregnancy; Pregnancy Trimester, First; Time Factors; Uterus

Topics: Acute Kidney Injury; Adult; Arteries; Capillaries; Cell Division; Epithelial Cells; Epithelium; Female; Fibrin; Hemolytic-Uremic Syndrome; Humans; Infarction; Kidney Glomerulus; Postpartum Hemorrhage; Pregnancy; Puerperal Disorders

Topics: Abortion, Septic; Blood Coagulation Disorders; Disseminated Intravascular Coagulation; Ethanol; Female; Fibrin; Hematoma; Humans; Leukemia; Liver Cirrhosis; Methods; Neoplasms; Phlebitis; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications, Hematologic; Sepsis

Topics: Agar; Blood Coagulation Disorders; Blood Coagulation Tests; Female; Fibrin; Fibrinolysis; Humans; Methods; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications, Hematologic; Serologic Tests

Topics: Amniotic Fluid; Aprotinin; Female; Fibrin; Humans; Postpartum Hemorrhage; Pregnancy; Uterine Inertia

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: Adolescent; Adult; Female; Fetal Death; Fibrin; Humans; Infarction; Placenta; Postpartum Hemorrhage; Pre-Eclampsia; Pregnancy

Topics: Adult; Blood Coagulation Disorders; Embolism, Amniotic Fluid; Female; Fibrin; Humans; Lung; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications, Hematologic

Topics: Female; Fibrin; Humans; Postpartum Hemorrhage; Pregnancy

Topics: Abortion, Induced; Afibrinogenemia; Blood Transfusion; Curettage; Female; Fibrin; Genital Diseases, Female; Gynecology; Hemorrhage; Humans; Postpartum Hemorrhage; Postpartum Period; Pregnancy; Thrombin; Uterine Hemorrhage

Topics: Capillary Permeability; Female; Fibrin; Fibrinolysin; Fibrinolysis; Hemorrhage; Histamine; Humans; Postpartum Hemorrhage; Postpartum Period

Topics: Female; Fibrin; Hemorrhage; Humans; Polymerization; Postpartum Hemorrhage; Postpartum Period; Pregnancy

Topics: Afibrinogenemia; Female; Fibrin; Hemorrhage; Humans; Postpartum Hemorrhage; Postpartum Period; Pregnancy; Pregnancy Complications; Thromboplastin

Topics: Embolism; Embolism, Fat; Female; Fibrin; Hemorrhage; Hemorrhagic Disorders; Humans; Postpartum Hemorrhage; Postpartum Period; Pulmonary Embolism

Topics: Blood Coagulation; Female; Fibrin; Fibrinolysis; Hemorrhage; Humans; Postpartum Hemorrhage; Postpartum Period; Pregnancy