Hemorrhagic diathesis in abruptio placentae

Dangerous Bleeding Associated with Carcinoma of Prostate

“…There was no obvious fibrinolytic activity to which proteolytic digestion of fibrinogen could be attributed. Nor do we know of any evidence to suggest that the mechanism is the same as that found in premature separation of the placenta (Stevenson et al, 1953) and perhaps in certain lung operations (Chalnot et al, 1952), where it seems that intravascular clotting may take place with consequent depletion of fibrinogen, as a result of the release into the circulation of excessive thromboplastin from the organ involved. The fibrinolytic factor, when it is present, is more easily understood, since tissue juices from a prostatic carcinoma have been shown in vitro to cause clot lysis and also to digest fibrinogen, factor V (ac-globulin), and probably prothrombin (Tagnon et al, 1953a(Tagnon et al, , 1953b.…”

Incoagulability of Blood After Accidental Haemorrhage

“…The important fact that the tendency to post-partum haemorrhage is associated particularly with severe accidental haemorrhage has also been emphasized by Weiner et al (1950Weiner et al ( , 1953, although Stevenson et al (1953) describe cases of haemorrhage following accidental haemorrhage which were of only "moderate" severity.…”

“…The coagulation defect is essentially transient and usually does not last more than 24 to 36 hours. Before delivery there is thus a danger of continuation of the retroplacental haemorrhage; Weiner et al (1953) suggest that artificial rupture of the membranes has a beneficial effect on the coagulation mechanism at this stage, but Stevenson et al (1953) say that the blood may remain incoagulable until delivery. The more serious complication is that the condition may continue long enough after the delivery to cause severe post-partum haemorrhage or bleeding from a section wound.…”

“…The critical level of plasma fibrinogen below which blood is incoagulable is stated to be in the region of 100 to 150 mg. per 100 ml. (Stevenson et al, 1953 ;Weiner et al, 1953).…”

“…The writer then goes on to make a plea that this variation of susceptibility to poliomyelitis should be taken into account in any statistical study of the value of prophylactic measures "-that is, lightand dark-haired people should be equally distributed in the control and experimental groups. Of recent years there have been several reports concerning the phenomenon of incoagulability of the blood which sometimes follows accidental haemorrhage (Dieckmann, 1936;Moloney et al, 1949;Weiner et al, 1950;Goodfriend et al, 1953;Stevenson et al, 1953;and Weiner et al, 1953). This blood incoagulability may give rise to severe post-partum haemorrhage, or to uncontrollable bleeding from the wound or even from suture points after caesarean section, and may be so severe as to cause death.…”