Coagulation and fibrinolysis in molar pregnancy

Uterine and Peripheral Hematologic Profiles in Molar Pregnancy

“…Finally, the combined effects, shortly before blood sampling, of psychologic tension, anesthetic medication and minor surgical stress could have contributed to the findings of the present study. However, the very similar results in a previous investigation with patients free of those influences (9) suggest that such potential contributions were not dominant in the present clinical model. Furthermore, since the main purpose of the study was to measure differences between local and peripheral blood samples, it was considered that the possible systemic effects of fear, stress and anesthetics would not be significant enough to cloud such differences, if present.…”

“…What the present study clearly indicates is that our clinical model and the conventional hematologic tests selected for the investigation were not sensitive enough to prove the initial postulate. Furthermore, the absence of clinically detectable uterine contractions in the four cases eliminated the most likely mechanisms involved in a process of intrauterine trophoblastic and hematologic conflicts, with subsequent necrosis and deportation of clumps of trophoblast (I, 6,9).…”

“…On the other hand, molar pregnancy is usually associated with a high secretion of chorionic gonadotropins and with a significant increase of trophoblast deportation. T h e former fact has been consistently associated with high fibrinogen levels (5,9) as in cases 1 and 3, raising the question of a possible effect of this hormone on hepatic physiology. T h e effect could occur either directly or through other ovarian and adrenal steroid substances (2), although the synergistic and protein anabolic actions of increased h u m a n placental lactogen production may also be involved (3,7).…”

“…A previous study of coagulation and fibrinolysis in molar pregnancy (9) suggested the presence of a latent state of hypercoagulability with a higher turnover rate of fibrinogen and increased levels of fibrinogen-fibrin degradation products. These were reportedly present even before the mechanism of expulsion began.…”