The fibrinolytic system in amniotic fluid embolism

Beller, F. K.; Douglas, Gordon C. C.; Debrovner, Charles H.; Robinson, Richard

doi:10.1016/s0002-9378(16)35142-0

Cited by 47 publications

(4 citation statements)

References 21 publications

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“…In in vitro studies, amniotic fluid has been shown to shorten whole-blood clotting time, to have a thromboplastin-like effect, to induce platelet aggregation and release of platelet factor III, to activate the compliment cascade, and to contain a direct factor X-activating factor. [25][26][27] However, Phillips and Davidson 28 concluded that the amount of procoagulant in normal amniotic fluid is insufficient to cause significant clinical intravascular coagulation. In 5 of the 14 animal studies 5,6 ' 8 " 10 discussed above, coagulopathy was inconsistently observed.…”

Section: Hemodynamic Effectsmentioning

confidence: 99%

Arachidonic Acid Metabolites and the Pathophysiology of Amniotic Fluid Embolism

Clark¹

1985

Semin Reprod Med

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Section: Hemodynamic Effectsmentioning

confidence: 99%

Arachidonic Acid Metabolites and the Pathophysiology of Amniotic Fluid Embolism

Clark¹

1985

Semin Reprod Med

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“…Symptome einer akuten Fibrinolyse wurden bei vorzeitiger Placentarlösung [2], bei Fruchtwasserembolie [5] und bei missed abortion [24] beobachtet.…”

Section: üBersicht üBer Das Schrifttumunclassified

über die fibrinolytische Aktivität des Euglobulins bei intakter Schwangerschaft und missed abortion

Uszyński¹,

Uszyńska-Folejewska²

1966

Gynecol Obstet Invest

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“…These patients have a fibrinolytic type of DIC 80 observed as unlike placental abruption autopsies of women who died due to amniotic fluid embolism lack evidence of fibrin deposition. 81 Moreover, Beller et al 82 studied the clotting and fibrinolytic systems of their patient in three blood samples: the first was drawn on admission, the second at the onset of shock and the third at the start of cardiac massage following cardiac arrest. Clotting parameters on admission were normal.…”

Section: Introductionmentioning

confidence: 99%

DIC in Pregnancy – Pathophysiology, Clinical Characteristics, Diagnostic Scores, and Treatments

Erez¹,

Othman²,

Rabinovich³

et al. 2022

JBM

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Obstetrical hemorrhage and especially DIC (disseminated intravascular coagulation) is a leading cause for maternal mortality across the globe, often secondary to underlying maternal and/or fetal complications including placental abruption, amniotic fluid embolism, HELLP syndrome (hemolysis, elevated liver enzymes and low platelets), retained stillbirth and acute fatty liver of pregnancy. Various obstetrical disorders can present with DIC as a complication; thus, increased awareness is key to diagnosing the condition. DIC patients can present to clinicians who may not be experienced in a variety of aspects of thrombosis and hemostasis. Hence, DIC diagnosis is often only entertained when the patient already developed uncontrollable bleeding or multi-organ failure, all of which represent unsalvageable scenarios. Beyond the clinical presentations, the main issue with DIC diagnosis is in relation to coagulation test abnormalities. It is widely believed that in DIC, patients will have prolonged prothrombin time (PT) and partial thromboplastin time (PTT), thrombocytopenia, low fibrinogen, and raised D-dimers. Diagnosis of DIC can be elusive during pregnancy and requires vigilance and knowledge of the physiologic changes during pregnancy. It can be facilitated by using a pregnancy specific DIC score including three components: 1) fibrinogen concentrations; 2) the PT difference -relating to the difference in PT result between the patient's plasma and the laboratory control; and 3) platelet count. At a cutoff of ≥26 points, the pregnancy specific DIC score has 88% sensitivity, 96% specificity, a positive likelihood ratio (LR) of 22, and a negative LR of 0.125. Management of DIC during pregnancy requires a prompt attention to the underlying condition leading to this complication, including the delivery of the patient, and correction of the hemostatic problem that can be guided by point of care testing adjusted for pregnancy.

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The fibrinolytic system in amniotic fluid embolism

Cited by 47 publications

References 21 publications

Arachidonic Acid Metabolites and the Pathophysiology of Amniotic Fluid Embolism

Arachidonic Acid Metabolites and the Pathophysiology of Amniotic Fluid Embolism

über die fibrinolytische Aktivität des Euglobulins bei intakter Schwangerschaft und missed abortion

DIC in Pregnancy – Pathophysiology, Clinical Characteristics, Diagnostic Scores, and Treatments

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