fibrin and Puerperal-Disorders

Preeclampsia is a devastating medical complication of pregnancy that can lead to significant maternal and fetal morbidity and mortality. It is currently believed that there is abnormal placentation in as early as the first trimester in women destined to develop preeclampsia. Although the etiology of the abnormal placentation is being debated, numerous epidemiologic and experimental studies suggest that imbalances in circulating angiogenic factors released from the placenta are responsible for the maternal signs and symptoms of preeclampsia. In particular, circulating levels of soluble fms-like tyrosine kinase 1, an antiangiogenic factor, are markedly increased in women with preeclampsia, whereas free levels of its ligand, placental, growth factor are markedly diminished. Alterations in these angiogenic factors precede the onset of clinical signs of preeclampsia and correlate with disease severity. Recently, the availability of automated assays for the measurement of angiogenic biomarkers in the plasma, serum, and urine has helped investigators worldwide to demonstrate a key role for these factors in the clinical diagnosis and prediction of preeclampsia. Numerous studies have reported that circulating angiogenic biomarkers have a very high negative predictive value to rule out clinical disease among women with suspected preeclampsia. These blood-based biomarkers have provided a valuable tool to clinicians to accelerate the time to clinical diagnosis and minimize maternal adverse outcomes in women with preeclampsia. Angiogenic biomarkers have also been useful to elucidate the pathogenesis of related disorders of abnormal placentation such as intrauterine growth restriction, intrauterine fetal death, twin-to-twin transfusion syndrome, and fetal hydrops. In summary, the discovery and characterization of angiogenic proteins of placental origin have provided clinicians a noninvasive blood-based tool to monitor placental function and health and for early detection of disorders of placentation. Uncovering the mechanisms of altered angiogenic factors in preeclampsia and related disorders of placentation may provide insights into novel preventive and therapeutic options.

Topics: Biomarkers; Bronchopulmonary Dysplasia; Cardiovascular Diseases; Female; Fetal Death; Fetofetal Transfusion; Fibrin; Humans; Hydrops Fetalis; Placenta Diseases; Placenta Growth Factor; Placentation; Pre-Eclampsia; Pregnancy; Prognosis; Puerperal Disorders; Up-Regulation; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factor Receptor-1

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

To assess the activation status of blood coagulation in thrombosis-prone pregnant women receiving a reduced dosage of heparin.. Forty-three women were given subcutaneous heparin treatment during pregnancy; the dosage was monitored so that the heparin (anti-Xa) level was within the stipulated range of 0.08-0.15 anti-Xa units 3 hours after injection. Several coagulation variables were investigated and some routine analyses were performed. The results were compared with those of a control group of 26 healthy pregnant women.. Compared with the control values, hemoglobin (P < .01), fibrinogen (P < .05), and total protein S (P < .01) were increased already before heparin treatment was started and continued to be increased significantly throughout pregnancy. During heparin treatment, protein C levels (P < .01) and the factors measured by prothrombin time (P < .001) were increased compared with the controls. Antithrombin decreased, though not as much as when patients are given therapeutic dosages. The fibrinolytic inhibitors behaved as in normal pregnancy. Three variables measuring thrombin formation or coagulation activation (ie, thrombin-antithrombin complexes, D-dimers, and soluble fibrin) were increased in a high proportion before heparin treatment was started; they normalized somewhat during treatment.. In early pregnancy, women with previous thrombotic episodes have high plasma levels of coagulation variables and of markers of coagulation activation compared with controls. Such changes may be used to predict the need for treatment and, in the future, to control treatment.

Topics: Adult; Antithrombin III; Female; Fibrin; Fibrin Fibrinogen Degradation Products; Fibrinogen; Heparin; Humans; Partial Thromboplastin Time; Peptide Hydrolases; Platelet Count; Pregnancy; Pregnancy Complications, Hematologic; Protein C; Prothrombin; Puerperal Disorders; Recurrence; Thrombin; Thromboembolism

Incidence, risk factors and morphological features of the intravascular coagulation (IC) in 160 women who had died during pregnancy, after abortion and delivery were studied. IC was established in 118 (73.8%) of them. The main risk factors leading to IC were shock (59.3%), sepsis (28.8%), toxemia of pregnancy (incl. eclampsia) (25.4%), Caesarean section (19.5%), fetal death in utero (12.7%), amniotic fluid embolism (9.3%), and abruptio placentae (7.6%). Disseminated intravascular coagulation (DIC) was established in 66% of the cases, and local intravascular coagulation (univisceral localisation of microthrombi) in 28%. In the resting 6% of the cases there was consumptive coagulopathy without microthrombi. Lungs, pituitary gland, uterus, kidneys and adrenals were the most frequently affected organs. Necrosis in the parenchymal organs, hyaline membrane formation in the lungs and consumptive coagulopathy were particularly frequent in the cases with DIC. The leading causes of death were acute renal failure and ARDS. It was established that prolonged intensive care including artificial ventilation, massive blood transfusion, as well as surgical treatment, aggravate the course and morphological features of IC.

Topics: Abortion, Spontaneous; Adult; Bulgaria; Capillaries; Cause of Death; Cross-Sectional Studies; Disseminated Intravascular Coagulation; Female; Fibrin; Humans; Incidence; Pregnancy; Pregnancy Complications, Hematologic; Puerperal Disorders; Risk Factors

This article deals with the clinical importance of antithrombin III (AT III) in renal disease. Patients with nephrotic syndrome demonstrates a high risk of thromboembolism. A renal AT III loss is an important pathogenetic factor in these events. Patients with serumalbumin below 2.0 g/dl are mostly endangered. In patients with acute oligoanuric renal failure low AT III-levels due to consumption were often found that lead to diminished protection against intravascular coagulation processes and can therefore contribute to progression of illness. An AT III-substitution may be of some benefit in these patients. Additionally AT III was given in patients with dialysis-dependent renal failure and low levels of AT III leading to a reduced incidence of thrombosis of the extracorporeal system. Unnecessary high doses were also avoided and a minimal heparinization could be performed more efficiently in bleeding risk patients. Furthermore, AT III-levels during renal transplantation and during organ rejection are reported.

Topics: Acute Kidney Injury; Antithrombin III; Antithrombin III Deficiency; Female; Fibrin; Humans; Kidney Diseases; Nephrotic Syndrome; Pregnancy; Puerperal Disorders; Risk; Sepsis; Thromboembolism; Thrombosis

The term "Endotheliotropic Hemolytic Nephroangiopathy" (EHN) comprises various clinically or pathomorphologically defined disease states with severe renal lesions (e.g. hemolytic uremic syndrome, malignant nephrosclerosis, post partum renal insufficiency) which, to date, have been considered as different entities. We attempted to assign accompanying glomerular changes based upon light and electron microscopy to the above mentioned clinical pictures and their various stages. The accordingly classified glomerular lesions (G1--G3 and Ga) are of critical importance in pathohistological differential diagnosis. Since it is assumed that fibrin is a causing event in the pathogenesis of the vascular lesions, quantitative evaluation of glomerular fibrin deposits was done. The results, when viewed with respect to time, lead to the conclusion that the microthrombotic component represents a secondary phenomenon. Thus, the primary and hence pathogenetically most important finding is a severe damage to the endothelium of the terminal renal vasculature. This endothelial damage although being expressed with variable intensity has to be regarded as the common denominator inherent to all types of glomerular lesions in EHN.

Topics: Acute Kidney Injury; Adult; Aged; Biopsy; Child; Child, Preschool; Female; Fibrin; Hemolytic-Uremic Syndrome; Humans; Infant; Kidney Glomerulus; Male; Microscopy, Electron; Middle Aged; Nephrosclerosis; Pregnancy; Puerperal Disorders

Topics: Female; Fibrin; Fibrin Fibrinogen Degradation Products; Fibrinogen; Humans; Methods; Pregnancy; Pregnancy Complications; Puerperal Disorders

The clinical and renal biopsy findings from two patients in whom renal functional abnormalities developed in the late postpartum period are described. Both biopsies showed fibrin deposition in the renal vasculature, in one case marked and in the other mild. The patient with the more severely damaged kidney subsequently died, and the other is alive but with evidence of slowly progressing renal damage. The clinicopathological spectrum and pathogenesis of late postpartum renal failure are discussed.

Topics: Acute Kidney Injury; Animals; Biopsy; Blood Coagulation; Disseminated Intravascular Coagulation; Ergot Alkaloids; Female; Fibrin; Fluorescent Antibody Technique; Hemolytic-Uremic Syndrome; Humans; Hypertension; Ischemia; Kidney; Kidney Glomerulus; Pregnancy; Puerperal Disorders

Soluble fibrin monomer complexes (SFMC) were determined in 12 patients following delivery, 2, 4, 6 days and 3 months post partum. Quantitative gel filtration (1 per cent agarose) of the beta-alanine-precipitated plasma samples yielded the relative (per cent of the total fibrinogen content) and absolute (milligrams per 100 ml. of plasma) amount of SFMC. During the early puerperium the amount of SFMC remained essentially constant, with average postpartum values of 6.3 +/- 1.2 per cent and 27.6 +/- 9.1 mg. per 100 ml. (mean and standard deviation). Three months after delivery the level of SFMC was significantly (p less than 0.001) decreased (3.3 +/- 1.3 per cent and 8.4 +/- 3.4 mg. per 100 ml.). The quantitative estimation of SFMC in the early puerperium as presented in this study indicates that a state of hypercoagulability can be evaluated by measuring the thrombin-mediated catabolic products of fibrinogen.

Topics: Adult; Female; Fibrin; Fibrinogen; Humans; Postpartum Period; Pregnancy; Puerperal Disorders; Thromboembolism

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: ABO Blood-Group System; Abortion, Spontaneous; Adult; Age Factors; Bacteriuria; Blood Coagulation; Blood Coagulation Tests; Blood Group Antigens; Delivery, Obstetric; Disseminated Intravascular Coagulation; Estrogens; Female; Fibrin; Fibrinogen; Fibrinolysis; Humans; Lactation; Parity; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Complications, Infectious; Protamines; Puerperal Disorders; Smoking; Staphylococcus; Time Factors

Topics: Acute Disease; Acute Kidney Injury; Adult; Biopsy; Blood Vessels; Capillaries; Female; Fibrin; Follow-Up Studies; Humans; Kidney; Kidney Glomerulus; Microscopy, Electron; Microscopy, Fluorescence; Pre-Eclampsia; Pregnancy; Prognosis; Proteinuria; Puerperal Disorders

Topics: Acute Kidney Injury; Adult; Anemia, Hemolytic; Azathioprine; Beta-Globulins; Biopsy; Female; Fibrin; Haptoglobins; Heparin; Humans; Obstetric Labor Complications; Oxytocics; Prednisone; Pregnancy; Puerperal Disorders

Topics: Adult; Afibrinogenemia; Blood Coagulation Disorders; Blood Coagulation Tests; Disseminated Intravascular Coagulation; Female; Fibrin; Fibrinogen; Fibrinolysis; Humans; Plasminogen; Pregnancy; Pregnancy Complications, Hematologic; Puerperal Disorders; Thrombin

Topics: Angiography; Blood Coagulation Tests; Brachial Artery; Deoxyribonuclease I; Female; Femoral Artery; Fibrin; Fibrinogen; Humans; Injections, Intra-Arterial; Perfusion; Plasminogen; Pregnancy; Puerperal Disorders; Serum Globulins; Streptodornase and Streptokinase; Streptokinase; Subclavian Vein; Thrombin; Thromboembolism; Thrombophlebitis