The coagulation and fibrinolysis system at vaginal delivery

Abstract

Introduction:The condition observed in coagulation activity during pregnancy was described as a "hypercoagulable state" (Alexander, 1955). Lately, it'sreported that acute intracascular coagulation often occurred during pregnancy and delivery, particularly in cases of toxemia of pregnancy, intrauterine death, abruptio-placentae and post-partum haemorrhage.The purpose of the present investigation is to research the extensive DIC in vaginal bleeding.Patients and Methods: According to bleeding volume in vaginal deliverys 163 cases were divided into two groups; the first group has lesser bleeding volume than 500ml (132 cases) and the second greater than 500ml (31 cases). Their specimen were drawn seriously in the full term or false labor, the first and second stage, 20 minutes after delivery and 3, 6, 12, 24 and 48 hours post partum, and the following determinations were made Fbg, platelet counts, FDP, eug LA, eug+SK LA (Sta), eug+SK LA (Htd), SFMC, PTT, PT, TT and PRT.Results: eug+SK LA (Std) and eug+SK LA (Htd) decreased from 20 minutes after delivery. SFMC showed arising from the first or second stage to 48 hours after delively. FDP increased from the first stage to 6 hour after delivery and decreased from 12 hours after delivery. Fbg gradually increased from the first stage to 20 minutes after delivery. Eug LA gradually decreased in the first and second stage, but 20 minutes after delivery increased in group I and remained unchanged in group II and gradually increased from 3 hours after delivery. Platelet counts decreased during 3, 6 hours after delivery.Discussion: Serial coagulation and fibrinolysis studies in vaginal delivery showed a pattern DIC such as decreased platelet count and fibrinogen level with