[Obstetrical coagulopathies--current understandings].
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Biomedical subjects
Publications and source records attributed to V Glavanakova.
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The desquamation of vascular endothelium was investigated in parturients after normal and operative delivery by cesarean section in dynamics up to the tenth day. There was increased endothelemia in both clinical groups up to the fifth postpartal day, after which the number of endothelial cells in plasma began to diminish lytically and it reached just the norm on the tenth day. Very high endothelemia up to 24th hour after cesarean section made impression. The increased desquamation of the vascular endothelium, as an objective manifestation for the presence of vascular lesions, in the clinical groups of women, examined by us, supported the concept for increased thrombotic risk during postpartal period. This risk is 6 times greater after operative deliveries by cesarean section according to literary data, which has been confirmed by our results for massive endothelial desquamation respectively for considerable vascular lesions within the first 24 hours after the operation and up to the fifth day inclusive. The possibility is discussed to add also vasoactive drugs with endothelium-stabilizing effect to the early antithrombotic prophylaxis with low doses of heparin in view of eventual reduction of vascular damages.
The degree of endothelial desquamation in circulation was studied in 75 pregnant women with grave from of preeclampsia between 28 and 40 weeks' gestation, but in 30 of them thrombocytic functions--adhesion and aggregation were examined as well. It was established that there was a statistically significant differences increase in the three examined parameters of pregnant women with preeclampsia in comparison with a control group of healthy pregnant women at the same gestational period. The significance of the increase in endothelial cells as an objective manifestation of vascular endothelial lesions is discussed. The obtained results are the first of this kind, reflect initial changes in the endothelial-thrombocytic phase of hemostasis and have relation to the pathogenesis of the disease.
The endothelial vascular desquamation was studied in 32 diabetic patients and 150 healthy controls. In the diabetic patients a significantly high desquamation was found. No differences in the desquamation due to the type of diabetes, I or II, and its duration were found. The authors are of the opinion that the early vascular desquamation is the result of the high glycemia.
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