Beller F K
Zentralbl Gynakol. 1987;109(3):145-51.
The syndrome of coagulation defects in obstetrics was detected as cause for obstetrical hemorrhage during the 50 years. Some of the etiologic factors like the dead fetus syndrome or the salting out syndrome have vanished. Amniotic fluid embolism is the only syndrome which is clearly associated with disseminated intravascular coagulation. This connection between premature separation is less clear. One concept assumes that the plasma fibrinogen concentration is low because it is consumed in the retroplacental hematoma. Heparin treatment can be fatal if DIC is mistaken with a "loss coagulopathy", which is at present mostly responsible for coagulation defects and obstetrical hemorrhage. This indicates a change in pattern of disease which is due to a better pathophysiologic understanding.
在过去50年中,产科凝血缺陷综合征被检测为产科出血的原因。一些病因,如死胎综合征或盐析综合征已经消失。羊水栓塞是唯一与弥散性血管内凝血明确相关的综合征。前置胎盘早剥与弥散性血管内凝血之间的联系尚不清楚。一种观点认为,血浆纤维蛋白原浓度低是因为它在胎盘后血肿中被消耗。如果将弥散性血管内凝血误诊为“失凝性凝血病”(目前这种病是导致凝血缺陷和产科出血的主要原因),肝素治疗可能是致命的。这表明疾病模式发生了变化,这是由于对病理生理学有了更好的理解。