Skip to main content
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1963 Mar;16(2):108–111. doi: 10.1136/jcp.16.2.108

A puerperal haemorrhagic state due to a heparin-like anticoagulant

M L N Willoughby 1
PMCID: PMC480507  PMID: 14000980

Abstract

The occurrence of a severe generalized haemorrhagic state in an obstetric case due to a heparin-like anticoagulant is described. This appeared in the post-partum period apparently following a compatible blood transfusion. The pattern of results found in conventional laboratory tests for elucidating acute blood coagulation disorders is described, and the distinction between heparinaemia and the defibrination syndrome emphasized.

Protamine sulphate corrected the clotting abnormality in vitro and when administered in amounts so as to achieve a similar concentration in vivo was followed by correction of the blood coagulation and the sudden cessation of bleeding from multiple sites.

Full text

PDF
108

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ALAGILLE D., SOULIER J. P. Action des enzymes protéolytiques sur le sang total in vitro; modifications des facteurs de coagulation et du complément. Sem Hop. 1956 Jan 30;32(7):355–359. [PubMed] [Google Scholar]
  2. BAKER S. J., JACOB E. A haemorrhagic disorder in pregnancy due to an "anticoagulant" preventing the conversion of fibrinogen to fibrin. J Clin Pathol. 1960 May;13:214–219. doi: 10.1136/jcp.13.3.214. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. BELL W. N. A coagulation defect due to an anticoagulant possessing antithromboplastic and antithrombic properties, probably heparin. Blood. 1951 Nov;6(11):1199–1203. [PubMed] [Google Scholar]
  4. HOUGIE C. Circulating anticoagulants. Br Med Bull. 1955;11(1):16–20. doi: 10.1093/oxfordjournals.bmb.a069439. [DOI] [PubMed] [Google Scholar]
  5. INGRAM G. I., MATCHETT M. O. A rapid "side-room" method for the determination of plasma fibrinogen concentration as fibrin. J Clin Pathol. 1960 Nov;13:469–474. doi: 10.1136/jcp.13.6.469. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. INGRAM G. I., NORRIS P. R., TANNER E. I. Acute coagulation disorders at parturition. A scheme of laboratory investigation, with illustrative case. J Obstet Gynaecol Br Emp. 1960 Jun;67:367–383. doi: 10.1111/j.1471-0528.1960.tb07014.x. [DOI] [PubMed] [Google Scholar]
  7. JURGENS J., STEIN F. Intravasale Gerinnung als koagulopathisches Syndrom nach manueller Lösung der Placenta. Schweiz Med Wochenschr. 1954 Mar 20;84(12):346–351. [PubMed] [Google Scholar]
  8. KREVANS J. R., JACKSON D. P. Hemorrhagic disorder following massive whole blood transfusions. J Am Med Assoc. 1955 Sep 17;159(3):171–177. doi: 10.1001/jama.1955.02960200017004. [DOI] [PubMed] [Google Scholar]
  9. LARSEN R. A. Hemorrhagic diathesis during pregnancy due to unexplained lack of vitamin K. A case report. Acta Med Scand. 1960 Jul 1;167:171–175. doi: 10.1111/j.0954-6820.1960.tb03533.x. [DOI] [PubMed] [Google Scholar]
  10. MASURE R., SCHOCKAERT J. A. Syndromes aigus consécutifs à une consommation accrue du fibrinogène en obstétrique. Gynaecologia. 1954 Jul;138(1):75–86. [PubMed] [Google Scholar]
  11. NIEWIAROWSKI S., KOPEC M. [Studies of the role of fibrinolysis in the pathogenesis of hemorrhagic diathesis]. Hemostase. 1961;1:237–241. [PubMed] [Google Scholar]
  12. NILSSON I. M., SJOERDSMA A., WALDENSTROM J. Antifibrinolytic activity and metabolism of 6-aminocaproic acid in man. Lancet. 1960 Jun 18;1(7138):1322–1326. doi: 10.1016/s0140-6736(60)92305-9. [DOI] [PubMed] [Google Scholar]
  13. QUICK A. J., HUSSEY C. V. Hyperheparinemia: report of a case. Am J Med Sci. 1957 Sep;234(3):251–258. [PubMed] [Google Scholar]
  14. RATNOFF O. D., VOSBURGH G. J. Observations on the clotting defect in amniotic-fluid embolism. N Engl J Med. 1952 Dec 18;247(25):970–973. doi: 10.1056/NEJM195212182472503. [DOI] [PubMed] [Google Scholar]
  15. SCHNEIDER C. L. Fibrin embolism (disseminated intravascular coagulation) with defibrination as one of the end results during placenta abruptio. Surg Gynecol Obstet. 1951 Jan;92(1):27–34. [PubMed] [Google Scholar]
  16. SHARP A. A., HOWIE B., BIGGS R., METHUEN D. T. Defibrination syndrome in pregnancy: value of various diagnostic tests. Lancet. 1958 Dec 20;2(7060):1309–1312. doi: 10.1016/s0140-6736(58)90579-8. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES