Fibrinolysis in Normal Pregnancy

Biezenski, J.J.; Moore, H. C.

doi:10.1136/jcp.11.4.306

Cited by 91 publications

(38 citation statements)

References 6 publications

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“…Within 24 hours of delivery, there was a rapid increase in fibrinolytic activity, control levels being attained within 24 hours. These findings, using another method and in another racial group, were in agreement with the findings of Biezenski and Moore (1958).However, the mechanism underlying these changes remains obscure. Whether the alteration in fibrinolytic activity during pregnancy is a function of fibrinolysin and/or precursors, antilysins, fibrin substrate, or a combination of these factors, is not known.…”

supporting

confidence: 88%

Fibrinolytic and Antifibrinolytic Activity in Pregnancy

1960

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Fibrinolytic activity and serum antifibrinolysin were estimated in normal pregnant women, during and after labour.The decreased fibrinolytic activity found during labour returned to non-pregnant levels within 24 hours of delivery. During the same period, the serum antifibrinolysin was rapidly diminished.It is suggested that the post-partum increase in fibrinolytic activity to non-pregnant levels is due to alterations in the fibrinolytic system itself, as well as to changes in circulating antifibrinolysin.In a previous communication alterations in fibrinolytic activity during pregnancy were reported (Gillman, Naidoo, and Hathorn, 1959). It was shown that, within 13 to 15 weeks of the onset of pregnancy, fibrinolytic activity, as measured by euglobulin lysis time, was greatly reduced and remained so until the second stage of labour. Within 24 hours of delivery, there was a rapid increase in fibrinolytic activity, control levels being attained within 24 hours. These findings, using another method and in another racial group, were in agreement with the findings of Biezenski and Moore (1958).However, the mechanism underlying these changes remains obscure. Whether the alteration in fibrinolytic activity during pregnancy is a function of fibrinolysin and/or precursors, antilysins, fibrin substrate, or a combination of these factors, is not known. To this end, serum antifibrinolytic activity was determined in nine pregnant African women, both during and after labour. Materials and MethodsPregnant African women in the first and second stage of labour were selected from the labour wards of the King Edward VIII Hospital. They were all medically healthy and obstetrically normal. In each of the women, determinations were made-during labour and nine to 24 hours after parturition.Collection of Blood.-The subjects were not under basal conditions. All blood samples were collected between 9 and 10 a.m. through a wide-bore needle inserted by clean venipuncture into the antecubital vein. The first few drops were discarded and 5 ml. of the freely flowing blood was collected in clean 1Ox70 mm. tubes containing 0.5 ml. of a 3.8% sodium citrate solution. The tubes were immediately placed in melting ice and transported to the laboratory.

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supporting

confidence: 88%

Fibrinolytic and Antifibrinolytic Activity in Pregnancy

1960

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“…The increase of plasminogen as shown in Fig. 2 Biezenski and Moore (1958) and confirmed by Shaper et al (1965). The euglobulin lysis time depends on the level of fibrinogen, plasminogen, and plasminogen activator.…”

Section: Resultssupporting

confidence: 54%

Fibrinolytic Enzyme System and Pregnancy

Bonnar¹,

McNicol²,

Douglas³

1969

BMJ

145

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Smmary: The effect of pregnancy on the components of the fibrinolytic enzyme system was determined by serial observations on 10 healthy women during normal pregnancy, labour, and the puerperium. The The haemostatic mechanism in pregnancy appears to be altered towards an enhanced capacity to form fibrin and a diminished ability to lyse fibrin. These changes may be a physiological development to ensure the integrity of the foetal and maternal circulations and provide rapid and effective haemostasis in the uterus during and after placental separation. Nevertheless, the changes may also establish a vulnerable state for intravascular fibrin deposition. Introduction The fibrinolytic enzyme system or plasminogen-plasmin system has a physiological role complementary to the coagulation mechanism in maintaining the patency of the blood vessels by promoting the removal of intravascular fibrin. The behaviour of the fibrinolytic mechanism in human pregnancy is therefore of special interest because an increase in the concentration of certain coagulation factors, particularly fibrinogen, is known to occur as pregnancy advances. Fibrinolytic activity has been reported to be decreased in late pregnancy, but many of the previous reports are single observations obtained under varying conditions and conflicting results have been presented. The purpose of this investigation was to elucidate the changes in the components of the fibrinolytic enzyme system induced by pregnancy and parturition by serial observations on a group of healthy women followed throughout normal pregnancy, labour, and the puerperium.According to current concepts the coagulation and fibrinolytic systems may be in a state of dynamic equilibrium which keeps the vascular compartment intact and patent, the coagulation system laying down fibrin on the vascular endothelium to seal any gaps which may occur, and the fibrinolytic system removing such fibrinous deposits after they have served their

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“…Red cell fragmentation and thrombocytopenia have been reported in eclampsia, with increased platelet stickiness in toxaemia (McKay, 1964;Morris, Vassalli, Belier, and McCluskey, 1964;Brain, Kuah, and Dixon, 1967;Bonnar, Davidson, Pidgeon, McNicol, and Douglas, 1969a). The increased levels of clotting factors and decreased fibrinolysis found in late pregnancy tend to favour fibrin deposition (Astrup, 1956;Biezenski and Moore, 1958;Pechet and Alexander, 1961;Talbert and Langdell, 1964;Nilsson and Kullander, 1967;Wardle and Menon, 1969;Bonnar, McNicol, and Douglas, 1969b).…”

Section: Resultsmentioning

confidence: 99%