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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to develop an experimental model for eclampsia, 22 female inbred Spontaneously Hypertensive Rats (SHR) were grafted with skin from Holtzman males. The implantation of four sequential grafts took place at an interval of ten days. Each SHR was mated with its corresponding skin donor ten days after the last graft. Five non grafted SHR mated with Holtzman males were used as controls. In most of the experimental rats that became pregnant we found changes which consisted in: low number of offspring, stillborn fetuses, abortions and growth delay. Renal function was evaluated before and during pregnancy showing a physiological increase in glomerular filtration of 7.5% (basal = 0.93 +/- 0.12 ml/min, peak = 1.00 +/- 0.12 ml/min) as compared with an increase of 166% (basal = 0.68 +/- 0.22 ml/min, peak = 1.85 +/- 0.33 ml/min) in the control group. Renal histology showed lesions corresponding to disseminated intravascular coagulation. These results indicate that the association of skin grafts and hypertension in these rats affects the normal development of pregnancy and suggest that immunological factors could be involved in experimental eclampsia.
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PMID:[Eclampsia induced by skin allografts in spontaneously hypertensive rats]. 248 14

From 1958 to 1987, 81 cases of pregnancy-related acute renal failure (PR-ARF) were observed (9% of the total number of acute renal failure [ARF] needing dialysis). In the three successive ten-year periods (1958-67, 1968-77, 1978-87) the incidence of PR-ARF fell from 43% to 2.8% with respect to the total number of ARF, and from 1/3,000 to 1/15,000 with respect to the total number of pregnancies. Maternal mortality was high (32%), with 5 cases of death in the last ten years. Irreversible renal damage was recorded in 11.6% of PR-ARF, and, in particular, in 26.3% of cases in preeclampsia-eclampsia (PE-E). Worse maternal and renal prognosis occurred in PE-E complicated by abruptio placentae. Neither disseminated intravascular coagulation (DIC), microangiopathic hemolytic anemia nor prostacyclin imbalance were significantly related to the severity of renal damage. Heparin therapy did not modify DIC evolution and renal outcome and was aggravated by severe hemorrhagic complications. In conclusion, PR-ARF has become a rare, but still critical occurrence, and the most effective measures would be a program of careful prevention.
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PMID:Pregnancy-related acute renal failure. 278 54

Incidence, risk factors and morphological features of the intravascular coagulation (IC) in 160 women who had died during pregnancy, after abortion and delivery were studied. IC was established in 118 (73.8%) of them. The main risk factors leading to IC were shock (59.3%), sepsis (28.8%), toxemia of pregnancy (incl. eclampsia) (25.4%), Caesarean section (19.5%), fetal death in utero (12.7%), amniotic fluid embolism (9.3%), and abruptio placentae (7.6%). Disseminated intravascular coagulation (DIC) was established in 66% of the cases, and local intravascular coagulation (univisceral localisation of microthrombi) in 28%. In the resting 6% of the cases there was consumptive coagulopathy without microthrombi. Lungs, pituitary gland, uterus, kidneys and adrenals were the most frequently affected organs. Necrosis in the parenchymal organs, hyaline membrane formation in the lungs and consumptive coagulopathy were particularly frequent in the cases with DIC. The leading causes of death were acute renal failure and ARDS. It was established that prolonged intensive care including artificial ventilation, massive blood transfusion, as well as surgical treatment, aggravate the course and morphological features of IC.
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PMID:Intravascular coagulation in relation to pregnancy and delivery. 281 60

Current concepts of the cause, pathophysiologic mechanisms, diagnosis, and management of acute and chronic DIC have been discussed. Considerable attention has been devoted to interrelationships that have remained confusing. Only by clearly understanding these pathophysiologic interrelationships can the clinician and laboratorian appreciate the divergent and wide clinical spectrum of often confusing clinical and laboratory findings in patients with DIC. Many of the therapeutic decisions to be made in these patients remain controversial and will remain so until more series of patients are published with respect to specific therapeutic modalities and survival patterns. Many syndromes that remain organ specific share common pathophysiologic properties with DIC but are identified as an independent disease entity, such as HUS, adult shock lung syndrome, eclampsia, and many other isolated organ-specific disorders. Many of these similar disorders, some systemic and some organ specific or multiorgan specific, are listed in Table 36.
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PMID:Disseminated intravascular coagulation and related syndromes: a clinical review. 305 30

Pregnancy-related acute renal failure (ARF) can include reversible tubular necrosis as well as irreversible cortical necrosis. Though pathogenetic mechanism are not fully understood, disseminated intravascular coagulation (DIC) probably plays a primary role. We report 25 cases of pregnancy-related ARF: 13 were associated with preeclampsia or eclampsia and 12 with obstetric complications. The following parameters were studied: partial thromboplastin, prothrombin and thrombin time, fibrinogen, anti-thrombin III and FDP levels, platelet count, whole blood clot lysis time and area, fragmented red cells (schistocytes) in the blood smear, hemoglobin, aptoglobin and LDH concentrations. DIC was scored in arbitrary units ranging from 12 to 36 and related to the clinical picture, renal outcome and the treatment employed. Five patients had irreversible renal damage, while 19 recovered fully; one patient died and no renal histology was available. The DIC score did not seem to have a significant relation to the severity of renal damage.
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PMID:The role of intravascular coagulation in pregnancy related acute renal failure. 322 77

Acute renal failure (ARF) is regarded as relatively uncommon in preeclampsia-eclampsia (PE-E) and, in any event, of moderate degree or reversible. Cortical necrosis is reported as rare, even in fatal cases. Little light has as yet been shed on the mechanisms responsible for ARF in PE-E. This paper describes 17 cases observed over the last 15 years, in which cortical necrosis (3 histological and 2 clinical diagnoses) was relatively frequent (29.4%). The severity of renal impairment did not appear to be related to chronological age, parity, period of pregnancy in which PE-E commenced and its duration prior to delivery, presence of frank eclamptic crises or the concomitance of earlier vascular or renal disease (p greater than 0.05). The superimposition of abruptio placentae (AP) was the only clinical factor significantly correlated with cortical necrosis (p greater than 0.05). The association PE-E + AP seems to be a particularly unfavorable prognostic sign for the kidney owing to the contribution of additional damage mechanisms (vasospasm, disseminated intravascular coagulation, hemorrhagic shock) furnished by AP, while PE-E itself prepares the ground for AP. The fact that PE-E is difficult to diagnose when AP is the onset symptom may be responsible for the underestimation of its contribution towards the induction of severe renal damage.
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PMID:Acute renal failure in preeclampsia-eclampsia. 342 11

Six women without hypertension or proteinuria, admitted for severe upper abdominal pain in the third trimester of pregnancy had elevated serum liver enzymes (SGOT, SGPT), markedly increased serum LDH levels, thrombocytopenia and abnormal blood coagulation tests, in particular low antithrombin III levels, indicating disseminated intravascular coagulation (DIC). Liver biopsies showed periportal and/or focal parenchymal lesions with large fibrin deposits, comparable to the liver lesions in eclampsia. Immunofluorescence (IF) showed microthrombi and large fibrin deposits. Three of the six women recovered spontaneously before delivery; in the remaining three all signs and symptoms rapidly disappeared after delivery. Perinatal outcome was poor. Seven women with pregnancy-induced hypertension and elevated serum liver enzymes constituted a reference series. Histopathological examination of liver biopsies in the reference group revealed periportal and/or focal parenchymal lesions in three whereas IF showed fibrin deposition in all seven, but less extensive than in the study group. The present findings indicate that upper abdominal pain in the last trimester of pregnancy can be caused by a syndrome of (pre)-eclamptic liver damage and DIC, even when hypertension and proteinuria are lacking.
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PMID:A syndrome of liver damage and intravascular coagulation in the last trimester of normotensive pregnancy. A clinical and histopathological study. 351 56

Pathomorphology of eclampsia is reviewed on the basis of literature data and it is noted that the problem has been studied insufficiently. Morphological features of eclampsia are subdivided into two groups; changes in the microcirculatory bed, that are generalized and undergo the following stages: spasm----wall swelling or necrosis----microthrombosis; and postischemic organ changes, such as dystrophy, necroses and hemorrhages. The role of disseminated intravascular coagulation syndrome is discussed in the development of some clinico-morphological features of eclampsia.
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PMID:[Pathomorphology of eclampsia]. 353 71

Serum levels of fibrinogen/fibrin degradation products, measured in African women, were significantly higher in pre-eclamptic toxaemia than in normal pregnancy, and were significantly higher with eclampsia than with toxaemia. These findings are in accord with the hypothesis that eclampsia and toxaemia are associated with disseminated intravascular coagulation, which may be responsible for certain clinical manifestations of these conditions.
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PMID:Fibrin degradation products in pre-eclamptic toxaemia and eclampsia. 545 55

A toxemia-like syndrome was induced in pregnant beagles by intraperitoneal inoculation of concentrates prepared from placentas of patients with preeclampsia-eclampsia and hydatidiform mole, which contained an agent, Hydatoxi lualba, that stained in a unique fashion with toluidine blue-O-. The pregnant dogs inoculated with either of these concentrates progressively developed hypertension, eyeground changes consistent with hypertensive retinopathy, proteinuria, disseminated intravascular coagulation, and hepatic dysfunction in addition to intrauterine growth retardation and intrauterine fetal death. Hepatic periportal hemorrhage and glomeruloendotheliosis, lesions usually seen in preeclampsia-eclampsia, were also noted to occur in pregnant beagles inoculated with these concentrates. A significant increased sensitivity to angiotensin II infusion was also noted. The toxemia-like syndrome did not develop in pregnant beagles when inoculated in a similar fashion with concentrates prepared from placentas from normal term pregnancies which were free of Hydatoxi lualba or in nonpregnant beagles inoculated with concentrates containing Hydatoxi lualba. Although the agent was not injected in pure form, the inoculation of concentrates containing Hydatoxi lualba appears to be required for the manifestation of the toxemia-like syndrome.
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PMID:Experimental induction of a toxemia-like syndrome in the pregnant beagle. 684 42


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