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C Manaka

Publications and source records attributed to C Manaka.

4 recordsLinked to original sources
PubMed1994

HELLP syndrome: CT evaluation.

Patients with the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) require careful observation and expedient delivery. However, those who develop this syndrome peripartum do not always fulfill its diagnostic criteria before labor begins. We investigated the potential usefulness of liver and spleen CT evaluation in identifying such patients. Seven patients with this syndrome were studied by CT scanning on postpartum days 0-3 and again 3-4 weeks after delivery. Although 3 patients with severe thrombocytopenia had a reduced liver-spleen CT number ratio (< 1.1) and subsequent normalization, the remaining 4 with less severe thrombocytopenia demonstrated no CT changes. Thus, antepartum evaluation of liver and spleen by CT may not be sensitive enough to detect patients who develop HELLP syndrome during the peripartum period. Serial examination of platelet counts may be more useful than CT in detecting patients at risk for this peripartum syndrome.

Adult↗
PubMed1991

[Changes in coagulability and fibrinolytic activity in the patients with ovarian hyperstimulation syndrome].

Ovarian hyperstimulation syndrome (OHSS) is occasionally seen following hMG-hCG treatment in combination with a GnRH agonist. Increased coagulability and decreased renal perfusion may be life threatening in some severe cases. In order to evaluate coagulo-fibrinolytic activity, several related factors in the general circulation were examined for approximately 2 weeks after admission in 11 patients with severe OHSS. The results are as follows. 1. Fibrinopeptide A (FPA) was increased during the initial stage of OHSS followed by a gradual decrease. However, the level remained slightly higher than normal for 2 weeks after the onset of severe OHSS. 2. Fibrinopeptide B beta 15-42 (FPB beta 15-42) showed grossly similar patterns to those of FPA. 3. D-dimer levels were constantly higher than normal from the initial to the late stages of OHSS. 4. Thrombin-Antithrombin III complex (TAT) was markedly increased on the days of admission followed by a gradual decrease during the following week. 5. Antithrombin III (ATIII), plasminogen and alpha 2 plasmin inhibitor (alpha 2PI) showed only minimal decreasing patterns throughout blood samplings. 6. Increases in FPA, FPB beta 15-42 and D-dimer were greater in the cases with severe hemoconcentrations. Our present data suggest that severe OHSS brings on hypercoagulability resulting in microthrombosis. In order to avoid development of coagulopathy, prophylactic treatment should be considered for patients with OHSS.

Adult↗