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At least 19 recordsLinked to original sources
PubMed1990

[The relationship between ophthalmoscopic changes and classification of toxemia in toxemia of pregnancy].

Based on ophthalmoscopic findings, 30 toxemic patients were divided into three types: R-type; retinal vascular occlusion type, C-type; choroidal vascular occlusion type, R + C-type; mixed vascular occlusion type. R-type (5 cases) and R + C-type (7 cases) significantly correlated to superimposed preeclampsia. C-type (18 cases) significantly correlated to preeclampsia (pregnancy-induced hypertensive disorder: PIH). Clinical examinations (urine protein, platelet, fibrinogen, fibrin degradation product, partial thromboplastin time and prothrombin time) had no relation to the types of ophthalmoscopic classification. It was concluded that preeclampsia (PIH) and superimposed preeclampsia have different influences on the ocular fundus.

Adult↗
PubMed1988

[Coagulation-fibrinolysis and kinin-forming systems in toxemia of pregnancy].

The changes in the coagulation-fibrinolytic system and kinin-forming system in toxemia of pregnancy were studied to clarify the relationship between the hemostatic system and severity of toxemia. The results obtained were as follows: 1) Both activity and antigen of antithrombin III (AT-III) and Factor XIII in toxemia of pregnancy were significantly lower than those of normal pregnancy, and became lower as the severity of toxemia increased. In particular, a significant negative correlation was observed between the total score for the gestosis index (G.I) and AT-III activity (r = -0.447, p less than 0.005). These results reveal that AT-III is not only a sensitive indicator of the hypercoagulable state but also a useful indicator of the severity of toxemia. 2) Plasma prekallikrein in toxemia became much lower, and bradykinin in toxemia became much higher than those of normal pregnancy. These results mean that there was not only activation of the coagulo-fibrinolytic system but also activation of the kinin-forming system in toxemia. 3) The plasmin-alpha 2-plasmin inhibitor complex in toxemia was significantly greater than that in normal pregnancy (p less than 0.001), and became very high as the severity of toxemia increased (p less than 0.05). In the mild toxemia group, the plasmin-alpha 2-plasmin inhibitor complex became greater as AT-III decreased and a significant negative correlation was observed (r = -0.59, p less than 0.05), whereas in severe toxemia, the complex did not increase as AT-III decreased and no correlation could be observed. These results show that in toxemia of pregnancy, the coagulation system dominates the fibrinolytic system as severity of toxemia increases.

Antithrombin III↗
PubMed1988

[The role of coagulation and fibrinolysis system in pathogenesis of toxemia of pregnancy].

UNLABELLED: It is well known that many pathophysiological findings in toxemia of pregnancy are explained by imbalance of coagulation and fibrinolysis system. The purpose of this study is to elucidate a precise role of coagulation and fibrinolysis system in pathogenesis of toxemia of pregnancy. SUBJECTS AND METHODS: 1) Classification of toxemia of pregnancy. Three hundred and thirty seven of toxemia of pregnancy are classified based on the onset period, and incidence of severity of disease and IUGR, rate of genetic factor of hypertension are compared in each group. 2) Platelet factor 4 (pf4) and beta-thromboglobulin (beta-TG), Fibrinopeptide A (FPA), thrombin-ATIII complex, ATIII fibrinopeptide B beta 15-42, D dimer FDP and plasmin-alpha 2 PI complex are assayed. The levels of PGI2, tissue plasminogen activator (tPA) and thrombomodulin (TM) are measured after venous occlusion. Immunoreactivity and biological activity of TM in urine are analyzed. 3) Aminoacid sequence of TM from normal and toxemia of pregnancy are determined by analyzing cDNA for TM. Moreover, TM are synthesized from recombined DNA and enzymological properties of TM obtained from normal and toxemia of pregnancy are compared. 4) Release of PGI2, tPA and TM by addition of thrombin are observed using monolayer culture of endothelial cells from cord. Enzymological properties of purified placental TM are analyzed. RESULTS: 1) The incidence of severe type, IUGR and the rate of patients who possess genetic factors for hypertension are higher in early onset type, suggesting that hypertension is the predominant characteristics in early onset type and that genetic factors for hypertension are tightly involved. 2) All parameters such as platelets, coagulation and fibrinolysis system are elevated in toxemia of pregnancy compared to those in normal pregnancy. Coagulation index that consists of above parameters is well correlated with clinical index that consists of clinical findings (r = 0.7006, p less than 0.0001). The net increase of PGI2, tPA and TM by venous occlusion are decreased along with severity of toxemia of pregnancy. The potency of production of PGI2 from endothelial cells in maternal omentum is impaired in the severe toxemia of pregnancy. Purified TM in urine from normal pregnancy and toxemia of pregnancy has 63K dalton of single band on SDS-PAGE. However, bioactivity/immunoreactivity ratio of TM in early onset type is lower than those in late onset type, and affinity of TM for thrombin and protein C is decreased in early onset type.(ABSTRACT TRUNCATED AT 400 WORDS)

Amino Acids↗
PubMed1990

[Blood coagulation and fibrinolytic studies in patients with toxemia of pregnancy].

In this study, blood coagulation and fibrinolytic parameters were measured in maternal blood and fetal umbilical cord blood in 200 normal pregnant women and in 46 with severe toxemia of pregnancy (Toxemia), and the relationships between fetal growth and concentrations protein C (PC), antithrombin-III (AT-III) and alpha 2-plasmin inhibitor (alpha 2-PI) were studied. 1. Significant increases in fibrin degradation products (FDP) and in plasminogen (Plg), AT-III and PC were found in maternal blood of Toxemia. A significant increase in AT-III and a decrease in alpha 2-PI and PC were observed in cord blood from these patients. 2. The platelet count (Pl) tended to be low in patients with Toxemia complicated by fetal growth retardation (IUGR). 3. Pl and fibrinogen (Fib) tended to be high in Toxemia complicated by normal fetal growth. 4. PC increased from early pregnancy, and a further increase was observed in the puerperium. 5. The PC concentration correlated with the AT-III but not with the alpha 2-PI concentration in maternal blood. 6. PC in cord blood was lower than that in maternal blood, and was correlated with AT-III and alpha 2-PI. 7. In patients with Toxemia, PC was reduced in both maternal and cord blood, and this correlated with AT-III as well as alpha 2-PI in maternal blood. 8. PC was low in Toxemia complicated by hypertension and proteinuria. These results suggest the involvement of FDP, AT-III, PC and Plg in the pathogenesis of Toxemia, and that the Pl, Fib, FDP and alpha 2-PI concentrations are related to fetal growth. Therefore, the PC and AT-III concentrations appeared to be a useful index for the blood coagulation and fibrinolysis in pregnant women and appeared to be important factors in the degree of Toxemia and IUGR.

Adult↗
PubMed1988

[Follow-up study on women suffered from severe toxemia of pregnancy].

We started a special follow-up system for women who had a history of severe toxemic pregnancy in our department since 1975. All medical records from 1956 to 1975 were reviewed and 468 deliveries with such disease were registered at that time. One hundred and ninety five deliveries (186 women) also were added from the prospective point of view until 1985. Among 654 patients, 374 women were available to address. I. The latter 186 women were divided into 7 groups: A1, A2, A3, A4, B1; and B2. The definitions of each group were as follows. A1: primipara with severe toxemia; A2: multipara that had a severe toxemia at the first time and then normal pregnancy (ies); A3: multipara that had a severe toxemia in the first pregnancy and then mild one(s); A4: multipara that repeated severe diseases; A5: multipara that had a severe toxemia and then unclassified type(s) of the disease; B1: multipara that had a normal pregnancy at the first time and then severe toxemia(s); B2: multipara that had a mild toxemia in the first pregnancy and then severe one(s). The percent of each group was 25, 24, 13, 15, 4, 6, and 12% respectively. Those women who had severe toxemia(s) were found to have hypertension, high levels of blood urea nitrogen, hyperhematocritemia, and hyperlipemia from the results of clinical and laboratory data. Consequently, they are a high risk group of atherosclerosis, because hypertension and hyperlipemia are main risk factors of that disease. II. Eighty percent of 374 women who had a history of severe toxemia from 1956 to 1985 was able to be followed up by us until 1987. Those women also were divided into the same groups as described above except A5, and checked up as to hypertension, hyperlipemia, body weight, and so on. The characteristic features were that the group A2 is in a well condition, and that many of group A4 are suffering from various diseases with regard to the remote prognosis. In conclusions, it was suggested that there may be four etiologic causes as to toxemia of pregnancy. The first is a disadaptation during pregnancy, and this seems to consist mainly of pregnancy induced hypertension. The second has various underlying diseases, such as chronic hypertension or renal disease, etc.. The third has a hypertensive trait which is manifested as the pregnancy advances. The fourth is considered to be related to biologic ageing.

Adult↗
PubMed1989

[Urinary calcium excretion in toxemia of pregnancy].

The amount of urinary calcium excretion is an useful marker for distinction between patient with preeclampsia and normal pregnancy of chronic hypertension has been reported. This study was performed to investigate the extent and the etiology of decrease in urinary calcium excretion in toxemia of pregnancy. The subjects in this study were 20 patients with severe toxemia of pregnancy (group T) and 20 subjects with normal pregnancy (group N). In these subjects, serum calcium (s-Ca), phosphate (s-Pi) and uric acid (s-UA) and urinary calcium (u-Ca), phosphate (u-Pi) and uric acid (u-UA) were measured. The values of u-Ca and u-Pi in the group T were significantly decreased than the group N (p less than 0.001, p less than 0.01). The values of s-Ca and s-Pi made no distinction between group T and group N. There was significant relationships between u-Ca and, s-UA (r = -0.70), clearance of UA (r-0.82), Ccr (r = 0.64), and FEca: Cca/Ccr (r = 0.87). These results indicated that the decrease of u-Ca was evident in severe toxemia of pregnancy. And the decrease of u-Ca has resulted from increase of tubular reabsorption. The change of u-Ca of patients with toxemia was studied. After the onset of toxemia, u-Ca was decreased rapidly (less than 50 mg/day) and u-Ca was restored to the normal range (more than 100 mg/day) promptly after delivery. The value of u-Ca was over 100 mg/day in the second pregnancy that developed on toxemia of pregnancy among the cases who has severe toxemia in the first pregnancy. However, toxemia of pregnancy have relapsed in the case with low u-Ca excretion of less than 100 mg/day during the second pregnancy.

Calcium↗
PubMed1987

[Tubular damage in toxemia of pregnancy using urinary trehalase as a marker].

We proved reversible tubular damage in edema and in toxemia of pregnancy using urinary trehalase as a marker. 1. Urinary trehalase activity in mild toxemia (edema: more than 0.5 kg body weight gain per week) was significantly increased as compared with normal pregnancy (less than 0.5 kg body weight gain per week) (p less than 0.02). Urinary albumin content, however, was not significantly changed with edema. 2. Toxemia of pregnancy showed significantly high urinary trehalase activity, NAG activity and beta 2-MG content as compared with the 3rd trimester of pregnancy. Urinary trehalase activity of severe toxemia was significantly higher than that of mild toxemia. Urinary NAG and beta 2-MG showed similar results to urinary trehalase. On the 5th and 30th puerperal days there was significantly lower trehalase activity than in the 3rd trimester. Urinary beta 2-MG in toxemia was significantly decreased at the 30th puerperal day as compared with the 3rd trimester and 5th puerperal day. However, no significant decrease was observed in urinary NAG. 3. Urinary trehalase activity in superimposed toxemia of pregnancy was significantly increased as compared with the 3rd trimester of pregnancy. However, urinary trehalase activity on the 5th puerperal day was significantly decreased, but was still significantly high. These results show that pregnancy with edema and pure toxemia of pregnancy cause renal tubular damage and this damage is reversible. In the stage of edema, no remarkable glomerular damage, but tubular damage could occur.

Female↗
PubMed1976

[Alpha 1 fetoprotein in pre-eclamptic toxemia (author's transl)].

From 1973 to 1975, 287 serum levels of alpha 1 fetoprotein in women with pre-eclamptic toxemia were determined. Pre-eclamptic toxemia was classified according to modified scheme of Goecke and Rippmann. 161 patients had mild pre-eclamptic toxemia (index 1-3), 72 patients had moderate pre-eclamptic toxemia (index 4-6), 54 patients had severe pre-eclamptic toxemia (index 7). In all types of severity of pre-eclamptic toxemia more levels of alpha fetoprotein were lower or higher than the normal levels including the standard deviations. The number of abnormal values rose with an increasing toxemia index. There was no statistically significant difference between too high values and too low values. Significantly more values were above and also below the normal values. Our investigations appear to indicate that the determination of the alpha fetoprotein is not only valuable as screening method for neural tube defects but also of value in the diagnosis and management of pre-eclamptic toxemia. Too high and too low values should not be differentiated but values both above and below the normal levels should be considered.

Adolescent↗
PubMed1989

[Relationship between coagulation-fibrinolysis kinetics and the severity and predictability of toxemia of pregnancy].

Various attempts have been made in recent years to identify the cause and pathophysiology of toxemia of pregnancy from the standpoint of changes in blood coagulation and fibrinolysis. It is believed that in toxemia of pregnancy, the fibrinolytic process changes as coagulation is augmented. However, definite conclusions about this sequence of events have not yet been reached. This study was designed to analyze the severity of toxemia of pregnancy and to examine the possibility of anticipating its onset from the standpoint of coagulation-fibrinolysis kinetics. The patient population comprised 116 women divided into 4 groups: I) A control group of 10 normal, nonpregnant women; II) Fifty-four normal pregnant women who were followed up from early pregnancy until delivery; III) Twenty-four women who were followed up from early pregnancy until delivery and developed toxemia of pregnancy; and IV) Twenty-eight women with severe toxemia of pregnancy of the pure type who were referred to our institution at the onset of the disease and were treated as inpatients. Intergroup comparison yielded the following results. 1. In group II (normal pregnancy), a significant increase was observed, first in fibrinopeptide B beta and then in fibrinopeptide A, as the pregnancy progressed. This suggested the acceleration of coagulation and fibrinolysis due to pregnancy. 2. In group III (6 of 24 cases developed severe toxemia of pregnancy), AT-III increased, while protein C and hematocrit levels increased relative to those on the normal pregnancy group during the 2nd trimester. Thus, changes in coagulation functions occurred before the onset of toxemia of pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Antithrombin III↗