The study of local fibrinolysis in abortion
Ikeuchi, M.
Nihon Sanka Fujinka Gakkai Zasshi 37(7): 1215-1223
1985
ISSN/ISBN: 0300-9165 PMID: 2411832 Document Number: 245092
This study investigates the possible role of local fibrinolysis (villous tissue fibrinolysis) in the pathogenesis of abortion by studying tissue fibrinolytic activity in tissue culture as well as blood coagulation, fibrinolysis, and the kinin system. Blood was collected by cubital venipuncture. Villous tissues were obtained by intrauterine evacuation from patients suffering from spontaneous abortion and patients with artificial abortion (as control). Patients in both groups had comparable gestational ages. Samples were obtained from patients visiting the outpatient department of the Nagoya City University Medical School during the 1978-82 period. In patients suffering from threatened abortion, serial blood samples were taken from the time symptoms emerged until the end of the disease. Between 1980-82 patients with spontaneous abortion were further separated into 2 groups: group A included those whose fetal cardiac activities had once been identified by ultrasonography. In group b patients, their fetal cardiac activities and never been identified. A tendency of low level of plasminogen was observed in patients with poor prognosis compared to normal control group. Serial samples also revealed a decline of plasminogen levels in this group. A recovery of plasminogen levels was observed in patients with good prognosis. Patients with poor prognosis showed a significant high level of Cl-inactivator compared to normal control group. In patients with good prognosis, a gradual decline of Cl-inactivator was observed like that seen in control group. Serial samples revealed a decrease of serum fibrin degradation products in patients with good prognosis. A significant decrease of fibrinogen was noted in patients with poor prognosis. There was a good correlation between the urokinase inhibition activity in normal villous tissue and the gestational age (6-11 weeks). The increased villous tissue fibrinolytic activity due to decreased urokinase inhibition activity may be 1 of the causes of abortion.