[Studies of coagulation-fibrinolysis system and cold insoluble globulin in cases of caesarean section].

In our previous study, we reported that pregnant blood was hypercoagulable and hypo-fibrinolytic. However, localized fibrinolytic activity, e.g. in the placenta, seemed to be present, because of increased FDP and fibrinopeptide B beta 15-42 during pregnancy. In this study, we tried to find out the changes in the coagulation-fibrinolysis system as well as cold insoluble globulin when stress such as operative procedure is being added. In 25 cases of cesarean section in full term pregnancy without onset of labor, blood samples were collected before operation, during operation and 3 hours, 6 hours, 12 hours, 24 hours and 48 hours post-operatively for estimation of the coagulation factors (FXII, IX, VIII, VII, X, V, II. XIII. Fbg), fibrinolytic factors (plg-Act, plg, SFMC, FDP), prekallikrein, plasma serin protease inhibitors (AT-III, alpha 2-PI, alpha 2-M, alpha 1-AT) and cold insoluble globulin. 30 normal term-pregnant women as well as 30 non-pregnant women were studied as the control. The result showed that the activities of both the intrinsic and extrinsic coagulation factors were markedly increased while the Fbg and AT-III were markedly decreased from during operation to 3 hours after operation. FXIII was markedly decreased and FII was slightly decreased from during operation. The marked decreases in prekallikrein, plg, alpha 2-PI, alpha 2-M, alpha 1-AT together and marked increases in plg-Act and FDP were noted from 3 to 12 hours after operation. A marked decrease in CIG was demonstrated immediately after the operation and continued until 48 hours after operation. These findings suggested that hypercoagulable state and secondary hyperfibrinolysis were associated during and after cesarean section. Decreases in Factor XIII and CIG seemed to be a general reaction in the mechanism of wound healing.