fibrin and Uterine-Hemorrhage

This mini-review summarizes some aspects of hemostatic defects, with particular reference to endometrial bleeding, both the normal menstruation and some bleeding disorders of the uterus. Two cell types are of particularly great interest in the hemostatic mechanism, viz. the platelet and the vascular endothelial cell. We will therefore start with a brief survey of the roles of platelets and vascular endothelium in hemostasis, and the underlying biochemical events will be discussed, particularly the participation of the arachidonate metabolites: the prostaglandins, the thromboxanes and the leukotrienes. This section is then followed by a brief description of some histological findings in the menstruating endometrium; the normal as well as the pathologically bleeding tissue. The possible roles of arachidonate metabolites in these events will be discussed. Several clinical studies have been published, in which various attempts have been made to treat excessive endometrial bleeding with inhibitors of prostaglandin biosynthesis. The findings in these studies are described. The relevance of this approach and its possible effects on other areas of arachidonic acid metabolism will be discussed. Finally, some studies will be summarized in which various attempts have been made to quantitate and endometrial prostaglandins in different physiological and pathological conditions.

Topics: Animals; Arachidonic Acid; Arachidonic Acids; Aspirin; Blood Platelets; Cyclooxygenase Inhibitors; Endometrium; Endothelium; Epoprostenol; Female; Fibrin; Hemostasis; Humans; Intrauterine Devices; Menstruation; Prostaglandin Endoperoxides; Prostaglandins; Thromboxane A2; Uterine Hemorrhage; Uterus

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: Bradykinin; Female; Fibrin; Fibrinogen; Fibrinolysin; Humans; Labor, Obstetric; Muscle Contraction; Muscle, Smooth; Obstetric Labor Complications; Oxytocin; Pregnancy; Uterine Hemorrhage; Uterus

To compare the efficacy of a fibrin preparation supplemented with tranexamic acid (Adhexil) with that of established devices, and to determine whether its effect is limited to the site of application.. Rabbit uterine horns were abraded in nonbleeding and bleeding variants of an established adhesions model. In a separate study, a sidewall excision with approximation of the abraded cecum was added. Animals randomly received Adhexil at both, neither, or either loci.. Laboratory study.. Seventy-two female New Zealand White rabbits (Oryctolagus cuniculus).. Adhexil, Seprafilm or SprayGel and Interceed.. The extent of adhesions was evaluated 13 to 16 days after surgery.. Adhexil reduced adhesions (15 +/- 7%; 15 +/- 4%) compared with controls (74 +/- 13%; 78 +/- 9%) in the bleeding and nonbleeding models, respectively. The reductions resulting from the use of Seprafilm (39 +/- 17%; 34 +/- 14%) or SprayGel (61 +/- 18%; 43 +/- 14%) (n = 4) were not statistically significant. In the bleeding model, Interceed (48 +/- 15%) reduced adhesions only modestly.. In the combined uterine and sidewall model, Adhexil reduced selectively the extent and incidence of adhesions. The absolute and relative performance of Adhexil in an established adhesions model and in the presence of bleeding justifies its further investigation.

Topics: Animals; Disease Models, Animal; Drug Combinations; Drug Evaluation, Preclinical; Female; Fibrin; Hemorrhage; Hyaluronic Acid; Postoperative Hemorrhage; Rabbits; Tissue Adhesions; Tranexamic Acid; Uterine Hemorrhage; Uterus

Fibrinogen St. Gallen I was detected in an asymptomatic Swiss woman. Routine coagulation tests revealed a prolonged thrombin and reptilase time. Functionally measured fibrinogen levels were considerably lower than those determined immunologically. Polymerization of fibrin monomers derived from purified fibrinogen was delayed in the presence of either calcium or EDTA. Normal fibrinopeptide A and B release by thrombin was established. An abnormal degradation of fibrinogen St. Gallen I by plasmin was observed. Fragment D1 of normal fibrinogen was fully protected against further proteolysis in the presence of 10 mM calcium, whereas fibrinogen St. Gallen I was partially further degraded to fragments D2 and D3. In the presence of 10 mM EDTA, the conversion of variant fragment D1 to D2 was accelerated whereas the degradation of fragment D2 to D3 was delayed in comparison to degradation of fragments D1 and D2 of normal fibrinogen. Three high-affinity calcium binding sites were found in both normal and variant fibrinogen. Mutation screening with SSCP analysis suggested a mutation in exon VIII of the gamma-chain gene. Cycle sequencing of this gene portion revealed a single base substitution from G to T of the base 7527, leading to replacement of gamma 292 glycine by valine. The same mutation has already been described for the fibrinogen variant Baltimore I. Molecular modeling was performed of a part of the gamma-chain containing the mutation site, based on recently published X-ray crystal structures of human fibrinogen fragment D and of a 30 kD C-terminal part of the gamma-chain. Significant structural alterations due to the substitution of glycine by valine at gamma 292 were observed, e.g. spreading of the protein backbone, probably leading to a modified accessibility of the plasmic cleavage sites in the gamma-chain at 356 Lys and 302 Lys. A shift of gamma 297 Asp that is involved in interactions of fragment D with the Gly-Pro-Arg-Pro-peptide was noted by molecular modeling. The latter observation is compatible with delayed polymerization of fibrin monomers.

Topics: Abortion, Spontaneous; Afibrinogenemia; Amino Acid Substitution; Binding Sites; Biopolymers; Blood Protein Electrophoresis; Calcium; DNA Mutational Analysis; Exons; Female; Fibrin; Fibrin Fibrinogen Degradation Products; Fibrinogens, Abnormal; Fibrinolysin; Humans; Menorrhagia; Middle Aged; Models, Molecular; Mutation, Missense; Nephelometry and Turbidimetry; Point Mutation; Polymerase Chain Reaction; Polymorphism, Single-Stranded Conformational; Pregnancy; Protein Conformation; Thrombin Time; Uterine Hemorrhage

The two main maternal vessels that are a major, if not the entire, source of maternal blood for the mouse placenta are unique in possessing intraluminal valvular projections. The morphologic configuration of these projections suggests their potential to converge, diverge, and rotate blood currents flowing under systolic pressure. The intravascular occurrence of circular fibrin bodies composed of concentric fibrin strands coagulated from the plasma and almost no blood cellular elements in these strands lends credence to this concept. Histopathologic changes in the extraembryonic and embryonic tissues induced by an intraperitoneal injection of 250 or 500 mg/kg of 2-methoxyethanol, or its metabolite, 2-methoxyacetic acid, via oral gavage were determined 48 hr after dosing CD-1 mice on day 11 of pregnancy. Both compounds caused 1) marked congestion and dilatation, associated with or without fibrinous occlusions, of the main maternal vessel of the placenta, 2) serosanguinous exudation and maternal hemorrhages from the placental periphery, 3) necrosis and desquamation involving the mesometrial surface or peripheral edge of the placenta, 4) translabyrinthine embryonic hemorrhage into the maternal circulation, and 5) embryonic hemorrhages into the exocoelomic, amniotic, and pericardial cavities. These lesions signify a disordered maternal circulation in the placenta suggestive of potentially serious pathologic effects. These lesions may play a role in the resorption, reduction in fetal body weight, and syndactyly or oligodactyly attributed to 2-methoxyethanol and 2-methoxyacetic acid.

Topics: Acetates; Animals; Ethylene Glycols; Female; Fetal Diseases; Fibrin; Hemodynamics; Hemorrhage; Mice; Placenta; Pregnancy; Pregnancy Complications, Cardiovascular; Regional Blood Flow; Uterine Hemorrhage

The levels of fibrinogen, monomeric fibrin soluble complexes (MFSC), fibrin-fibrinogen degradation products (FDP), and the status of blood coagulation and fibrinolytic systems were studied in girls suffering from juvenile uterine bleedings. Fibrinogen and MFSC levels were found lowered and FDP concentration increased in such bleedings. Fibrinogen concentration correlated with the activities of the coagulating and fibrinolytic systems, and the MFSC level only with the coagulating system activity. Mathematical analysis has revealed a relationship between blood fibrinogen metabolism and the activities of the coagulating and fibrinolytic systems, whose functions in this condition are relatively autonomous.

Topics: Adolescent; Age Factors; Blood Coagulation; Child; Female; Fibrin; Fibrin Fibrinogen Degradation Products; Fibrinogen; Fibrinolysis; Humans; Uterine Hemorrhage

Topics: Abortion, Induced; Amniotic Fluid; Blood Cell Count; Blood Coagulation Disorders; Blood Coagulation Tests; Blood Platelets; Factor VIII; Female; Fibrin; Fibrinogen; Humans; Hypertonic Solutions; Plasminogen; Pregnancy; Serum Globulins; Sodium Chloride; Solubility; Thromboplastin; Time Factors; Uterine Hemorrhage

Topics: Adolescent; Blood Coagulation Factors; Blood Platelets; Child; Factor XIII; Female; Fibrin; Humans; Microscopy, Electron; Uterine Hemorrhage

Topics: Animals; Endometrium; Female; Fibrin; Fibrinolysis; Hemostasis; Humans; Hysterectomy; Rabbits; Uterine Diseases; Uterine Hemorrhage; Uterus

Topics: Abortion, Induced; Atrophy; Cesarean Section; Extraembryonic Membranes; Female; Fibrin; Humans; Labor, Obstetric; Obstetric Labor Complications; Obstetric Labor, Premature; Obstetrics; Pathology; Placenta; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Trimester, Second; Uterine Hemorrhage

Topics: Abortion, Induced; Abortion, Spontaneous; Afibrinogenemia; Female; Fibrin; Fibrinogen; Fibrinolysis; Hemostasis; Humans; Pregnancy; Uterine Hemorrhage

Topics: Endometrium; Female; Fibrin; Humans; Pathology; Uterine Hemorrhage

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

Topics: Decidua; Estradiol; Female; Fibrin; Fibrinolysin; Humans; Menorrhagia; Menstruation; Metrorrhagia; Placenta; Pregnancy; Uterine Hemorrhage

Topics: Female; Fibrin; Hemorrhage; Humans; Menorrhagia; Metrorrhagia; Pregnancy; Syndrome; Thrombosis; Uterine Hemorrhage; Uterus

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