Sanarelli-Shwartzman-Phänomen bei febrilen Fehlgeburten und schweren Schock- und Blutungszuständen in der Geburtshilfe

Pneumococcal Sepsis With Generalised Shwartzman Reaction

“…Good results with such treatment have been reported in patients with chronic consumption syndromes, which might occur in malignant disorders (25). In the acute disease heparin treatment has often been recommended (1, 7, 21, 33), and even to patients where bleeding was the dominant symptom (13), but the results have been inconsistent (6), the mortality of treated patients high (4 out of 5 in one of the series), and control material absent or insufficient. The problem is that the action of heparin is mainly prophylactic; and if it is to have the desired effect it should be given early in the disease, because late in the disease it may accentuate the then existing bleeding tendency (6).…”

Coagulation Disturbances with Manifest Bleeding in Extrahepatic Portal Hypertension and in Liver Cirrhosis

“…The finding, in connection with thoracic surgery, that an increased apparent AHFactivity is often combined with a marked shortening of the coagulation time, as measured in plastic tubes, might indicate that such a n increase in A€-IF-activity could be an expression of hypercoagulability (14).Thesuggestion that such amechanism is a n important cause of bleeding has been supported b y promising clinical effects obtained with heparin administration in certain postoperative bleeding states of this type (14), as well as by observations in a case of liver cirrhosis made independently by Johansson (1 9). I n this connection it might be mentioned that heparin treatment has also been given with good clinical eKect in other diseases, where coagulation studies indicated a hypercoagulable state (3, 21,29). Table II.…”

Endotoxin Shock in Pregnancy

“…The protec tive action of heparin in laboratory animals was described in the previous chapter. The adm inistration of heparin in treatm ent of severe endotoxin shock in hum ans was reported by Pfau and Lascli [41]. The septicemia and shock with complete afibrinogenemia is caused by massive E. coli infection as a consequence of abortion.…”

“…P32 labelled endotoxin was found in larger am ount in the circulation of shocked animals, probably because of the reduc tion in the detoxifying potential of reticuloendothel system [44]. Hypofibrinogenemia and intravascular precipitation of fibrin in the capillaries of the lungs, liver and intestines associated with irre versible shock in septic abortion have been reported by m any authors [11,12,23,29,34,36,41,42]. M cKay and Saphiro [32] made an extensive study on the alteration in the blood coagulation system in the generalized Schwartzman reaction.…”