Table Of ContentS. Suzuki· W.E. Rathaway
J. Bonnar· A.R. Sutor
(Eds.)
Perinatal Thrombosis
and Hemostasis
With 126 Figures
Springer Japan KK
Professor SHIGENORI SUZUIa, M.D.
College of Medical Technology, Hokkaido University, Kita-ku, Sapporo 060, Japan
Professor WILLIAM E. HATHAWAY, M.D.
University of Colorado School of Medicine, Denver, CO 80262, USA
Professor JOHN BONNAR, M.D., FRCOG
University of Dublin, Trinity College, Department of Obstetrics and Gynaecology, St. James's
Hospital, Dublin, IreJand
Professor ANTON H. SUTOR, M.D.
Universităts-Kinderklinik, 7800 Freiburg, Federal Republic of Germany
Library of Congress Cataloging-in-Publication Data
Perinatal thrombosis and hemostasis / S. Suzuki ... [et al.] (eds.)., p. cm. IncJudes bibliographical
references. IncJudes index.
1. Blood coagulation disorders in pregnancy. 2. Blood coagulation disorders in 'infants. 3.
Thrombosis. 4. Hemostasis. 1. Suzuki, Shigenori, 1936- . [DNLM: 1. Blood Coagulation
Disorders-in infancy & childhood. 2. Blood Coagulation Disorders-in pregnancy. 3. Hemo
stasis. 4. Pregnancy Complications, Hematologic. 5. Thrombosis. WQ 252 P445j.
RG580.B56P47 1990 618.3-dc20 DNLM/DLC for Library of Congress 90-10190
© Springer Japan 1991
Originally published by Springer-Verlag Tokyo in 1991.
Sotcover reprint of the hardcover 1s t edition 1991
This work is subject to copyright. AII rights are reserved, whether the whole or part of the material is
concemed, specifically the rights of translation, reprinting, reuse of iIlustrations, recitation, broad
casting, reproduction on microfilms or in other ways, and storage in data banks.
The use of registered names, trademarks, etc. in this publication does not imply, even in the absence
of a specific statement, that such names are exempt from the relevant protective laws and regulations
and therefore free for general use.
Product Iiability: The publisher and the editors can give no guarantee for information about drug
dosage and application thereof contained in this book. In every individual case the respective user
must check its accuracy by consulting other pharmaceuticalliterature.
Typesetting: Asco Trade Typesetting Ltd., Hong Kong
ISBN 978-4-431-65873-3 ISBN 978-4-431-65871-9 (eBook)
DOI 10.1007/978-4-431-65871-9
Preface
Hemorrhage and thrombosis are major hazards for pregnant women and their
newborn infants. This book is concerned with the developmental mechanisms,
the diagnosis and treatment, as well as the prevention of these hemorrhagic and
thrombotic disorders.
The topics discussed in this volume, (1) perinatal hemorrhage in mothers and
their offspring; (2) coagulation disorders complicating pregnancy; (3) neonatal
intracranial hemorrhage; and, (4) vitamin K deficiency in the neonate, will help
bridge the gap between basic scientists and clinicians and between the pediatri
cian and the obstetrician. Hopefully, all those concerned with preventing these
disorders will be stimulated by the information and questions raised in the fol
lowing presentations.
Acknowledgements
We wish to thank Professors Takeshi Abe (Vice President, Teikyo University),
Nobuyoshi Shinagawa (Hirosaki University), Hiroaki Soma (Tokyo Medical
College), Tamotsu Miyazaki and Keisuke Sakurada (Hokkaido University) for
their helpful advice.
SHIGENORI SUZUKI
WILLIAM E. HATHAWAY
JOHN BONNAR
ANTON H. SUTOR
SHIGENORI SUZUKI. * 1936 in Sapporo, Japan. M.D., Uni
'versity of Hokkaido, 1963. Lecturer, Hokkaido Univer
sity, 1974. Alexander Humboldt-Foundation Scholarship,
Free University of Berlin. University of Munich, 1974-
1976. Foriner President, Japanese Society of Obstetrical,
Gynecological, and Neonatal Hematology. President of
International Symposium on Perinatal Thrombosis and
Hemostasis (1989 Sapporo). Professor, College of Medi
cal Technology affiliated with Hokkaido University since
1983.
WILLIAM E. HATHAWAY. * 1929 in Oklahoma, USA.
M.D., University of Oklahoma, 1954. Fellow in Pediatric
Hematology, University of Colorado School of Medicine,
1959. Head, Section of Pediatric Hematology-Oncology
and Director of Special Coagulation Laboratory, U ni
versity Hospital, 1973-1988. Professor of Pediatrics
(1973-1988) and Professor Emeritus (since 1988), Uni
versity of Colorado School of Medicine.
JOHN BONNAR. * 1934 in Wishaw, Scotland. M.B., CH.B.,
University of Glasgow, 1958. M.D. with Honours, Uni
versity of Glasgow, 1971. Elected to the Fellowship of the
Royal College of Obstetricians and Gynaecologists, 1972.
M.A., University of Dublin, 1976. Professor and Head,
Department of Obstetrics and Gynaecology, Trinity Col
lege, University of Dublin since 1975.
ANTON H. SUTOR. * 1938 in Augsburg, Germany. M.D.,
Freiburg University, 1964. Fellow of Pediatric Hematolo
gy, Mayo Clinic (USA), 1969. Awarded the Goedecke
Research Prize from Freiburg University, 1973 and the
Alexander-Schmidt-Prize from the German Society of
Haemostaseology, 1975. Professor of Pediatrics, Miinster
University since 1977. Head, Pediatric Hematology and
Hemostaseology, University of Freiburg, Children's Hos
pital since 1982.
Contents
Preface............................................................... V
List of Contributors ................................................... XI
Part 1. Perinatal Hemorrhage in Mothers and Newborns (Diagnosis, Treatment,
and Case Reports)
Diagnostic Value of Fibrin-and Fibrinogen
Degradation Products in Perinatology
1.1 The Diagnostic Value of Fibrin-and Fibrinogen Degradation
Products in Perinatology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
R. HAFfER and H. GRAEFF
1.2 Bedside Diagnosis of Acute Obstetrical DIC . . . . . . . . . . . . . . . . . . . . . 11
M.MAKI
1.3 Analysis of 'Y-'Y Dimer and Factor XIII (Fibrin Stabilizing Factor,
FSF) During Pregnancy and Labor .............................. 21
S. SUZUKI, H. GRAEFF, and R. HAFfER
1.4 Perinatal Emergencies in Sapporo Medical College .............. 33
E. HORIMOTO, E. SATOHISA, T. SANO, and M. HASHIMOTO
1.5 Can We Predict Bleeding in Pregnancy? Computer Graphic
Analysis of Obstetric Bleeding .................................. 39
S. SUZUKI, T. MURAMATU, and T. TERAO
ATIII
1.6 AT III in Pregnancy and Newborn Infants ....................... 47
H.E. KARGES
VIII Contents
1.7 Thrombin-Antithrombin III Complex and D-Dimer in Neonates:
Signs of Thrombin Generation During Birth ..................... 57
W. MUNTEAN, M. DANDA, and H. ROSEGGER
1.8 Effect of Antithrombin III Concentrate for DIC in Obstetrics
and Gynecology: The Changes of Prostanoids in Plasma Before
and After Administration .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
H. SUZUKI, M. KASAI, K. SATOH, H. lIDA, H. SUZUKI, and
1. NISHIYA
Perinatal Coagulation and Fibrinolysis
1.9 Perinatal Coagulation and Fibrinolysis .......................... 77
J. BONNAR, L. DALY, and B.L. SHEPPARD
1.10 The Relationship Between the Onset of Labor Mechanisms and
the Blood Coagulation System .................................. 91
S. SUZUKI, H. MATSUDA, and W. SAKAMOTO
1.11 Perinatal Problems of Thrombosis and Hemostasis . . . . . . . . . . . . . . . 103
B. ÂSTEDT
The Coagulation System in the Newborn lnfant
1.12 Anticoagulant and Thrombolytic Therapy in the Newbom 113
M. ANDREW and B. SCHMIDT
1.13 Regulatory Mechanisms Controlling Prothrombin and the
Development of Blood Coagulation Factors During Gestation . . . . 125
C.T. KISKER, D. BOHLKEN, S. PERLMAN, A.L. OLSON,
J. ROBILLARD, and W. CLARKE
1.14 Neonatal Thrombosis: A Critic al Appraisal of the Available
Evidence on Prevention, Diagnosis, and Treatment .. . . . . . . . . . . . . 137
B. SCHMIDT and M. ANDREW
Part 2. Pregnancy Complicated with Coagulation Disorders
Trophoblastic Disease, Placenta, etc.
2.1 Coagulation and Fibrinolytic Activity in Trophoblastic Disease ... 147
H. SOMA and H. OGAWA
2.2 Placental Protein 19 in Clinical Blood Coagulation Disorder . . . . . . 155
M. TAKAYAMA, K. ISAKA, Y. SUZUKI, H. FUNAYAMA, Y. SUZUKI,
K. AKIYA, and H. BOHN
Contents IX
2.3 Platelet Aggregation Inhibition Activity of Placental Brush Border
Membrane ..................................................... 165
H. lIOKA, 1. MORIYAMA, S. AKADA, M. AKASAKI, K. NABUCHI,
H. HISANAGA, K. MORIMOTO, and M. IeHUO
Coagulation Disorders During the Perinatal Period
2.4 Hematopoietic Malignancies During the Perinatal Period ........ 169
H. KOBAYASHI, S. HASHINO, K. ABE, M. TANAKA, M. IMAMURA,
M. MORIOKA, K. SAKURADA, and T. MIYAZAKI
2.5 Thrombocytopenia Associated with Type IIB VOn Willebrand's
Disease of Pregnant Identical Twins ............................. 175
M. IEKO, M. YOSHlKAWA, S. SAKURAMA, A. SAGAWA,
T. YASUKOUCHI, and S. NAKAGAWA
ITP During Pregnancy
2.6 Management of Pregnancy Complicated with Idiopathic
Thrombocytopenic Purpura: A Review of 16 Cases .............. 181
T. MATSUYAMA, K. IWASAKI, and A. Fum
2.7 The Management of Immunologic Thrombocytopenic Purpura
(ITP) During Pregnancy ........................................ 189
M. NAKABAYASHI, K. TAKAGI, T. MIMURO, S. MUSHIAKI,
Y. TAKEDA, and SAKAMOTO
2.8 Thrombocytopenia in Pregnancy ................................ 195
J. BONNAR
Part 3. Brain Hemorrhage (Including Vitamin K Deficiency)
Basic Research of Hemostasis During the Perinatal Period
3.1. Absorption, Metabolism and Storage of K Vitamins in the
Newborn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
M.J. SHEARER
3.2 Vitamin Kl and K Contents in Blood, Stool and Liver Tissues of
2
Neonates and Young Infants .................................... 213
A. SHlRAHATA, T. NAKAMURA, and N. ARIYOSHI
3.3 The Role of Hemostasis in Neonatal Intracranial Hemorrhage . . . . 225
W.E. HATHAWAY
x Contents
Vitamin K Deficiency 1
3.4 Vitamin K Prophylaxis and Late Onset Hemorrhagic Disease of
the Newborn in West Germany During 1988 ..................... 231
U. GOBEL, R. VON KRIES, and C. PETRICH
3.5 Vitamin K Deficiency and Breast-Feeding 239
R. VON KRIES
Vitamin K Deficiency 2
3.6 The Third Nationwide Survey on Vitamin K Deficiency in Infancy
in Japan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
T. NAGAO and Y. HANAWA
3.7 Time Interval Between Vitamin K Administration and Effective
Hemostasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
A.H. SUTOR and W. KONZER
3.8 Effect of Vitamin K Prophylaxis on the Incidence of the Late Form
of Vitamin Deficiency Bleeding ................................. 263
A.H. SUTOR and O. SCHARBAU
lntracranial Hemorrhage
3.9 Antithrombin III Administration in Premature Infants with
Intracranial Hemorrhage ....................................... 271
T. IKENouE, S. IBARA, T. HIRANO, and Y. NINOMIYA
3.10 Six Cases of Alpha-l-Antitrypsin Deficiency Presenting as a
Bleeding Diathesis with Intracranial Hemorrhage in the Newborn 277
G. AUERSWALD and A.H. SUTOR
Index................................................................. 285
List of Contributors
Abe, K. 169 Ikenoue, T. 271 Petrich, C. 231
Akada, S. 165 Imamura,~. 169 Robillard, J. 125
Akasaki,~. 165 Isaka, K. 155 Rosegger, H. 57
Akiya, K. 155 Iwasaki, K. 181 Sagawa, A. 175
Andrew,~. 113,137 Karges, H.E. 47 Sakamoto, S. 189
Ariyoshi, N. 213 Kasai,~. 65 Sakamoto, W. 91
Âstedt, B. 103 Kisker, C.T. 125 Sakurada, K. 169
Auerswald, G. 277 Kobayashi, H. 169 Sakurama, S. 175
Bohlken, D. 125 Kries, R. von 231,239 Sano, T. 33
Bohn, H. 155 Kiinzer, W. 257 Satoh, K. 65
Bonnar, J. 77,195 ~aki,~. 11 Satohisa, E. 33
Clarke, W. 125 ~atsuda, H. 91 Scharbau, O. 263
Daly, L. 77 ~atsuyama, T. 181 Schmidt, B. 113,137
Danda,~. 57 Mimuro, T. 189 Shearer, M.J. 203
Fujii, A. 181 ~iyazaki, T. 169 Sheppard, B.L. 77
Funayama, H. 155 ~orioka,~. 169 Shirahata, A. 213
Gobel, U. 231 ~orimoto, K. 165 Soma, H. 147
Graeff, H. 3,21 ~oriyama, 1. 165 Sutor, A.H. 257,263,
Hafter, R. 3,21 ~untean, W. 57 277
Hanawa, Y. 249 ~uramatu, T. 39 Suzuki, H.1. 65
Hashimoto,~. 33 ~ushiaki,S. 189 Suzuki, H.K. 65
Hashino, S. 169 Nabuchi, K. 165 Suzuki, S. 21,39,91
Hathaway, W.E. 225 Nagao, T. 249 Suzuki, Yo. 155
Hirano, T. 271 Nakabayashi,~. 189 Suzuki, Ya. 155
Hisanaga, H. 165 Nakagawa, S. 175 Takagi, K. 189
Horimoto, E. 33 Nakamura, T. 213 Takayama,~. 155
Ibara, S. 271 Ninomiya, Y. 271 Takeda, Y. 189
Ichijo,~. 165 Nishiya, 1. 65 Tanaka,~. 169
leko,~. 175 Ogawa, H. 147 Terao, T. 39
lida, H. 65 Olson, A.L. 125 Yasukouchi, T. 175
lioka, H. 165 Periman, S. 125 Yoshikawa,~. 175
