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Biomedical subjects

P W Howie

Publications and source records attributed to P W Howie.

At least 109 records · Page 6Linked to original sources
PubMed1976

Use of coagulation tests to predict the clinical progress of pre-eclampsia.

The clinical manifestations of severe pre-eclampsia are normally separated from those of mild pre-eclampsia and normal pregnancy on arbitrary grounds. A clinical index, based on the increase in diastolic blood-pressure and the presence of proteinuria, was developed to reflect the spectrum of disease from mild to severe pre-eclampsia. This was related to a coagulation index based on the platelet-count, plasma-factor-VIII, and serum-fibrinolytic-degradation-products. The two indices were shown to be strongly correlated. All cases of perinatal death associated with pre-eclampsia had coagulation indices in the most severely abnormal range. These results suggest that intravascular coagulation is a highly characteristic feature of pre-eclampsia and that the coagulation index may be of value in monitoring the progress of the disease.

Blood Cell Count↗
PubMed1976

Soluble fibrinogen/fibrin complexes in pre-eclampsia.

Significantly increased concentrations of soluble fibrinogen/fibrin complexes were found in plasma samples from ten normal pregnant women when compared with ten non-pregnant age-matched controls. In ten women with pre-eclampsia mean soluble complex concentration was more than three times that in the age, parity, and gestation matched pregnant controls. Soluble fibrinogen/fibrin complexes are also found in the plasma of patients in various hypercoagulable and thrombotic states, including disseminated intravascular coagulation. These findings provide additional evidence that pre-eclampsia is associated with disseminated intravascular coagulation.

Antigens↗
PubMed1975

Elective induction of labour. A randomised prospective trial.

In a prospective, randomised trial, 111 obstetrically normal pregnant women, who had elective induction of labour performed between 39 and 40 weeks, were compared with 117 controls who were managed expectantly until 41 weeks. Compared with the controls, the patients who had elective induction of labour had significantly less meconium staining in labour and a smaller blood-loss after delivery. The mean length of labour, the amount of pethidine used, and the Apgar scores at 1 minute were similar in the two groups. In the electively induced group, the caesarean-section rate was lower and the use of epidural analgesia more common than in the controls, but the differences were mot statistically signficant. The hour of delivery was similar in the two groups, suggesting that convenience to medical and nursing staff would not be greatly changed by elective induction of labour. There was no evidence that the hazards to mother and child were increased by elective induction, and its use might improve perinatal mortality by reducing the number of unexplained mature stillbirths.

Adolescent↗
PubMed1975

The effects of stilboestrol and quinestrol upon coagulation and fibrinolysis during the puerperium.

Two oestrogens, stilboestrol and quinestrol, were used to inhibit lactation and their effects upon coagulation and fibrinolysis were compared with control patients before delivery, during the puerperium and six weeks after delivery. During the first week of the puerperium, stilboestrol therapy was associated with rises of factors IX and X and quinestrol therapy with rises of factors IX and II. Six weeks after delivery, the clotting factors were similar to the control values in those who had received stilboestrol but factor II was still raised in the quinestrol treated patients. Additionally, a significant rise of factor X in the quinestrol group was noted at this time. Plasma antithrombin levels rose during the first week of the puerperium in all three groups but, six weeks after delivery, they were lower in those who had received oestrogens. Stilboestrol and quinestrol were also associated with a rise of plasminogen and antiplasmin concentration during the first week of the puerperium. Six weeks after delivery, quinestrol treated patients still had raised levels of plasminogen and antiplasmin while the stilboestrol treated patients only had raised levels of antiplasmin. These changes in coagulation and fibrinolysis are similar to those reported during oral contraceptive therapy. The persisting changes six weeks after delivery in women who had taken quinestrol might indicate an increased thrombogenic risk when long acting oestrogen preparations are used to inhibit lactation.

Antithrombins↗
PubMed1975

Failure of heparin therapy to affect the clinical course of severe pre-eclampsia.

In view of the association between pre-eclampsia and disseminated intravascular coagulation, three patients presenting with severe pre-eclampsia before the 28th week of pregnancy were treated with heparin. In all three patients, there was deterioration of hypertension and proteinuria that necessitated the withdrawal of treatment after five to six days. During treatment, serum and urinary fibrinolytic degradation products (FDPs) continued to rise or remained unaltered, plasminogen levels showed a steady fall, and the platelet count remained at a reduced level. These data suggest that heparin was an ineffective form of treatment and did not prevent the intravascular fibrin deposition associated with severe pre-eclampsia.

Blood Cell Count↗
PubMed1973

Effect of intravenous prostaglandin E 2 on platelet function, coagulation, and fibrinolysis.

Prostaglandin E(2) (PGE(2)) was infused intravenously to eight women for the termination of pregnancy and tests of platelet function: coagulation and fibrinolysis were studied before and during the infusion.Platelet adhesiveness, as measured by a cellophane membrane test-cell system, was significantly diminished by PGE(2), a change which was not noted by the glass-bead column technique. The administration of PGE(2) caused more rapid platelet disaggregation following ADP-induced aggregation but had no effect on the platelet count, collagen-induced aggregation, or platelet factor 3 activity. An increase in plasma antithrombin concentration and euglobulin lysis activity was also noted. These results support the concept that prostaglandin E(2) might have a role in the prevention of thrombosis.

Abortion, Induced↗
PubMed1972

Serum -macroglobulins in renal disease and preeclampsia.

The serum levels of alpha(2)-macroglobulin and pregnancy-associated globulin (another alpha-macroglobulin) have been measured by means of a radial immunodiffusion technique in (1) renal disease with and without proteinuria, (2) in age- and sex-matched controls, (3) in preeclampsia with and without proteinuria, and (4) in normal pregnant controls. There are significant increases in alpha(2)-macroglobulin and pregnancy-associated globulin in renal disease accompanied by proteinuria but normal levels are found in renal disease without proteinuria. Compared with normal pregnancy, alpha(2)-macroglobulin is significantly raised in preeclampsia with proteinuria but normal in preeclampsia without proteinuria. In contrast, serum pregnancy-associated globulin is significantly reduced in preeclampsia both with and without proteinuria when compared with normal pregnancy.

Adolescent↗