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

Results of tests based on the hypothesis that sustained release of an antifibrolytic agent from an IUD may control the bleeding complications associated with IUD contraception are reported. Devices releasing epsilon aminocaproic acid (EACA) were made from silicone rubber encased in nylon-baked millipore tubes. These devices were cylindrical with a diameter of 1.9 mm and lengths of 14 mm. For easy removal a central core of stainless steel extended beyond 1 end to form a closed loop. Menstrual blood loss (MBI) in a group of Rhesus monkeys was quantitated before and after insertion of a nonmedicated silicone device, a standard polyethylene device, or medicated silicone devices. A beneficial effect of medication with EACA was demonstrated. With nonmedicated silicone devices MBL increased 96% over preinsertion values. EACA-releasing devices caused only a 33% increase during the first menstrual period after insertion. Mean MBL was increased 109% in animals wearing polyethylene IUDs alone and 132% in those wearing polyethylene plus control silicone devices. MBL was increased only 44% in monkeys wearing polyethylene plus EACA medicated silicone devices. In animals with EACA devices no local or disseminated intravascular coagulation was detectable by assay of circulating levels of fibrinogen, plasminogen, or fibrin-fibrinogen degradation products. Although the effects of EACA occurred at a high intrauterine dose for only 1 menstrual period, a much smaller dose might be effective. Studies are being made to fabricate a device that would last for 1 year or more in humans. Complete inhibition of fibrinolytic activity in the uterus at the time of menstruation would be harmful so it is not sought.
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PMID:Intrauterine medication with epsilon aminocaproic acid. Effect on Rhesus monkeys wearing intrauterine devices. 112 54

Tubeless cutaneous ureterostomy by Toyoda's method was conducted in 67 ureters from 43 patients during the last 9 years. Subjects included 30 males and 13 females, with an average age of 61.4 years. Most of them were afflicted with malignant tumors in the bladder, rectum, prostate, or uterus. For bilateral ureterostomy, the double-barrel method was performed in which the stoma was made at the same site in both the right and left ureters. Among 60 ureters in which pre- and postoperative changes in the renal pelvis could be traced by IVP, satisfactory results were obtained in 16 of 20 ureters treated by unilateral surgery. Of the 40 ureters treated by the double-barrel method, moderate or severe pyeloectasis was observed in 3 of the 20 ureters on the side of the stoma, while moderate pyeloectasis was seen in 3 of 20 ureters of the side opposite the stoma, and severe pyeloectasis or loss of renal function was noted in 5. Thus, renal function on the side opposite the stoma was frequently influenced by the procedure. A patient who died of disseminated intravascular coagulation syndrome soon after the operation was excluded from analysis. Tubeless cutaneous ureterostomy could be conducted in 39 of 42 patients (92.8%), excluding one whose stoma and its periphery were covered with severe inflammatory granulation and 2 with ureteral constriction.
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PMID:Clinical results of tubeless cutaneous ureterostomy by Toyoda's method. 206 4

A 19-year-old woman underwent termination of pregnancy by dilatation and evacuation at 19 weeks of gestation. She subsequently developed persistent massive hemorrhage, with laboratory evidence of a consumption coagulopathy. Attempts to control bleeding were unsuccessful, and the patient underwent a hysterectomy. Pathologic evaluation of the uterus revealed embolization of fetal tissues and placental fragments in the uterine and parametrial veins. This is the first reported case of such a finding, and its importance in relation to the patient's clinical presentation is discussed.
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PMID:Fetal parts embolization during termination of pregnancy: report of a case. 229 2

We studied contact factors and kinin-kallikrein in normal non-pregnant and pregnant women, FXII deficient toxemia and DIC. The results obtained are as follows: 1. The levels of plasma prekallikrein, high molecular weight kininogen, kallikrein inhibitor, and C-1 INA were gradually decreased at delivery, and the levels of kallikrein like activity and bradykinin were increased during pregnancy and at the time of parturition. These facts indicate that kinin kallikrein systems played important role in uterine contraction. 2. The levels of contact factors (FXII and FXI) were lower at delivery than those of term. 3. In rat uterus, specific binding of bradykinin was observed by the method of radio receptor assay in the pelet of 10,000 X g fetal membranes, and its activity was 38%. 4. A synthetic kallikrein inhibitor (OS-291, MS) and bradykinin antagonist inhibited completely spontaneous uterine contraction of Wistar rats during delivery. 5. In the case of FXII deficiency, the levels of plasma prekallikrein, high molecular weight kininogen were normal, but at delivery, these levels were lower than those of term. The levels of kallikrein like activity which was half of normal parturition level was increased at parturition. 6. In cases of DIC (17) and severe toxemia (22), plasma prekallikrein levels were lower than the normal controls. The decrease was due to consumption of plasma prekallikrein to kallikrein activation.
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PMID:[Physiopathology of kinin forming system in reproduction]. 259 38

Multiple pelvic fractures and explosive-type uterine lacerations occurred in a previously healthy 17-year-old primigravida involved in a motor vehicle accident. The fetus suffered a crushed skull and was completely extruded with the placenta from the uterus. Treatment was complicated by severe disseminated intravascular coagulation with secondary fibrinolysis. Thrombelastography enabled us to rapidly evaluate the patient's coagulation status and to monitor her response to goal-directed therapeutic interventions (surgery, specific blood product therapy and epsilon-aminocaproic acid).
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PMID:Multiple uterine rupture and crushing injury of the fetal skull after blunt maternal trauma. A case report. 262 42

A 30-year-old woman in the 36th week of her second pregnancy, suddenly developed jaundice with remarkable liver necrosis, accompanied by generalized bleeding due to disseminated intravascular coagulation (DIC). She underwent a caesarean and a dead foetus was extracted from the uterus. Heparin and frozen plasma infusion resulted in a prompt recovery from the haemostatic disorder. The course of the disease involved the successive appearance of haemorrhagic shock, intestinal ileus and pulmonary embolism all of which she recovered from. The liver biopsy showed severe cholestasis without derangement of the lobular structure. Hypotheses of acute veno-occlusive disease caused by the DIC, and acute fatty liver of pregnancy are discussed.
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PMID:[Disseminated intravascular coagulation and acute hepatic necrosis at the end of pregnancy. A case report]. 262 77

After exercising on a trampoline, a 29-year-old primigravidae in the 16th week of gestation was admitted to our hospital with the clinical signs of premature ablatio placentae and acute coagulation disturbances with disseminated intravascular coagulation and uncontrolled secondary hyperfibrinolysis. The coagulation disturbance was stabilized by conservative therapy (Substitution with fresh-frozen-plasma (ffp), whole blood and low-dose heparin treatment without having to terminate the pregnancy by evacuation of the uterus. An appropriate antifibrinolytic treatment was not performed in this case. The continuous controls of fibrinmonomeres and reptilase time indicate the possibility of a persisting latent coagulation disturbance after the acute phase. Thus, the necessity of a low-dose heparin therapy after an acute coagulation disturbance becomes evident.
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PMID:[Disseminated intravascular coagulation disorder in the 2d trimester of pregnancy. Case report from the 16th week of pregnancy with spontaneous parturition at term]. 277 55

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

The authors report three cases of rupture of the uterus during delivery, complicated by an acute defibrination syndrome. Death resulted in two cases. The sequence of rupture of the uterus----shock----pathological condition of coagulation----great increase in the shock occurred in all three patients. This sequence could only be arrested in one of the three patients who had a total hysterectomy. Partial hysterectomy in the other two was ineffective. These three case histories suggest that total hysterectomy after even partial correction of the haemorrhagic state can be the best treatment in this very serious condition.
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PMID:[Uterine rupture causing acute defibrination syndrome. Apropos of 3 cases]. 379 17

Several parameters of hemostasis have been studied in 19 patients suffering from abruptio placentae. In 10 of them severe hemostatic alterations were detected and in 5, disseminated intravascular coagulation was observed. The patients were divided into four groups according to the severity of their clinical picture. The degree of placental separation was related to the severity and course of the clinical history and to the alterations in hemostasis detected at the most critical clinical moment. The analytical parameters were evaluated after extraction of the thromboplastic material. A good correlation was observed between the severity of the clinical picture and the degree of placental separation and the greatest analytical alteration, especially with cross-linked soluble fibrin monomer complexes (SFMC). In 9 of the 19 patients who showed analytical and/or clinical alterations, an improvement was detected in these alterations after evacuation of the uterus.
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PMID:Abruptio placentae and disseminated intravascular coagulation. 397 75


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