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KMID : 0382719710020010045
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Medical Journal of the Han-il Hospital
1971 Volume.2 No. 1 p.45 ~ p.51
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Analysis of the Result of Annual Physical Examination For Industrial Workers, 1971
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Abstract
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During gestation many factors required for coagulation are increased so that the usual obstetric patient comes to delivery adequately supplied with the prerequisites for hemostasis. Nevertheless, an occasional´ patient with congenital or acquired defects may experience an extensive hemorrhagic episode.
Women with deficiencies of the first stage, or thromboplastin generation requirements, seldom show bleeding problems in normal vaginal deliveries. If cesarean section or extensive trauma are encountered replacement is needed to prevent subsequent hemorrhage.
Deficiencies of the second, or prothrombin conversion stage of coagulation.. can result in bleebing both after vaginal delivery and following surgical procedures. Severe deficits of these substances probably require prophylactive measure during labor while minor ones may be left untreated unless bleeding becomes, abnormal.
In the third stage of coagulation, fibrinogen is obviously required for formation of a fibrin clot. Relatively low levels of fibrinogen (less than 100 mg per cent) are sufficient to achieve this purpose in the absence of fibrinoytic activity.
It is excessive activation of the fibrinolytic system (fourth stage of coagulation) that results in the most vigorous hemorrhage in both vaginal deliveries and surgical procedures. Under such circumstances fibrinogen levels between 100 and 200 mg percent may be insufficient and administration of fibrinogen may be required. In extreme cases of fibrinolytic activity, and preferably after delivery of the baby, inhibitors of the fibrinolytic system may become essential
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