[Effect of combined use of dextran sulfate and urokinase in cases of preeclampsia-behavior of blood coagulation-fibrinolysis and inhibitor systems].

UNLABELLED

In the severe cases of toxemia of pregnancy, the coagulation-fibrinolysis pattern and the morphological findings of the kidney suggest participation of chronic DIC. Accordingly, it is considered that management of mother and fetus by administration of drugs with anticoagulant and fibrinolytic activities may be useful.

METHOD

For 17 cases of preeclampsia (gestosis index, 9.1 +/- 1.5) daily dose of 3,000-1,500mg DS and 48,000 IU of UK were administered intravenously by one shot or drip (10-30 minutes) twice daily. The following clinical and laboratory examinations were done: Gestosis index (GI), blood pressure (BP), edema, urine volume, urine protein, Ccr (ml/min), platelet counts, PT, PTT, PRT, TT, factors XII, IX, VIII, X, VII, V, II and XIII, Fbg, ELT, eug + SKLA(Std), Plg, SFMC, serum and urine FDP, AT-III, C1-INA, alpha 2-PI, alpha 2-M and alpha 1-AT.

RESULT

In the preeclamptic women, increases in intrinsic coagulating factors, marked decreases in the extrinsic coagulating factors, depletion of ELT, rise in SFMC, marked increases in blood and urine FDP, and decreases in AT-III and alpha 2-PI were observed, suggesting the presence of chronic DIC. After administration of DS and UK, improvement of clinical findings such as a fall of BP, disappearance of edema, reduction in urine protein, and increase in Ccr were observed. In addition, normalization of the intrinsic system, recovery of the extrinsic system, ELT and serum FDP to normal levels, increasing tendency of Plg, AT-III, alpha 2-PI, alpha 2-M, alpha 1-AT, and disappearance of urine FDP were demonstrated at the same time. It is therefore concluded that this treatment for severe preeclampsia seems to be effective.