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KMID : 0378019610040030047
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New Medical Journal
1961 Volume.4 No. 3 p.47 ~ p.66
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Variations in Blood Coagulation in the Parturient Women and Newborn Infants
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Abstract
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Various disorders due to changes in blood coagulation mechc.nism such as thromboembolism, hypo- or afibrinogenemia have frequently been observed in the fields of ctstetrics. In fact hemorrhage, one of the major causes of maternal death in obstetrics is not infrequently derive,: from the disorders in blood coagulation. As to the possible causative factors for such changes there are some speculations such as direct influences from the fetus, placenta or amniotic fluid, stress and shock caused by labor pains, physiological hemorrhage in postpartum, abruptio placentae, fetal death in utero, retentio placentae, and toxemias.
On the other band, hemorrhagic disorders such as intracrar_ial bleeding in the newborn can also frequently be observed during or after delivery.
The purpose of the study is to evaluate the variations in coagulation factors of the blood cf the parturient women and the newborn infants (cord blood), on the basis of the recent advanced knowledge on blood coagulation..
The results obtained are as follows.
1) Heparin tolerance test as a global test on blood coagulation factors was used for the blood cf 30 parturients before delivery, 31 after delivery and 32 newborns. .
As compared with the test on the blood of normal subjects, that of the parturients before delivery showed significant acceleration. while that of the parturients after delivery railed to show significant variation. and the newborns revealed considerable delay. The umbilical blood taken from 32 newborns revealed considerable delay- compared with those of parturients before and after delivery. A significant difference was observed between those before and after delivery.
2) Recalcification time as a global test on blood coagulation factors was measured for the blood of 32 parturients before delivery, 39 after delivery and 45 newborns.
As compared with normal subjects, slight but ncn-significant acceleration was observed in the blood of parturients before and after delivery, and considerable delay in the cord blood of the newborns. No significart difference between the parturients before and after delivery was observed while the cord blood showed considerable difference from them.
3) The number of platelets was counted for the blood of 43 parturients before, 36 after delivery, 41 newborns, 30 healthy adult males and 32 non-pregnant women. In healthy subjects, no significant sexual difference was observed with the average count of 214, 000.
Significant increase in number was obzerved in the parturients before delivery as compared with those after delivery, even though it was not a remarkable increase in number comparing with that of normal subjects. The number of platelets of cord blood showed considerable decrease compared with those of normal subjects and the parturients before and after delivery.
4) Thromboplastin time (prothrombin time) was measured for the blood of 47 parturients before delivery, 42 after delivery and 44 newborns.
The thromboplastin time of the parturient´s blood taken before and after delivery showed acceleration, more marked in the former, whereas that of the newborns were delayed.
5) The amount of prothrombin was measured for the blood of 28 parturients before delivery, 27 after deliver- and 32 new-borns. Comparing with the normal subjects, the amount of prothrombin was markedly increased in parturients before and after delivery, but decreased in newborns. INTO significant difference between those before and after delivery was observed.
6) The activity of Labile factor (Factor V) was measured for the blood of 30 parturients before delivery, 24 after delivery and 36 newborns.
This factor was significantly increased in the parturients before and after delivery, whereas it was decreased in the newborns. No significant difference was observed between parturients before and after delivery.
7) The activity of Stable factor (Factor VII) was checked for the blood of 28 cases of parturients before delivery, 27 after delivery and 31 newborns. The result was nearly parallel to that of labile factor, and it increased markedly in the parturients either before or after delivery, but remarkably decreased in the newborns. No significant difference between those of the parturients before and after delivery was observed.
8) The amount of fibrinogen was measured for the blood of 40 cases of parturients each before and after delivery, and 39 newborns. It was increased in amount in the parturients either before and after delivery, whereas it was significantly decreased in the newborns. A considerable difference between those of the parturients before and after delivery was observed.
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