López-Llera M, de la Luz Espinosa M, Ramos J N, de León M D
Am J Obstet Gynecol. 1977 Apr 15;127(8):855-60. doi: 10.1016/0002-9378(77)90118-1.
Coagulation and fibrinolysis tests were performed in 14 patients with hydatidiform mole before any significant therapy was given and again, after evacuation of the mole, in eight instances. The results were compared with those found in a group of ten volunteers with normal pregnancies. The most frequent abnormalities in the problem cases were a shortening of the partial thromboplastin time and a prolongation of the thrombin time. From a total of seven cases with complete hematologic profiles before and shortly after evacuation of the mole, first showed important drops in platelets and fibrinogen. The most altered profiles occurred after expulsion of the mole in cases with important previous uterine activity. The findings suggested a latent state of hypercoagulability with higher turn over rate of fibrinogen and increased levels of fibrinogen-fibrin degradation products, that may exist even before the mechanism of expulsion begins. It was concluded that the alterations in coagulation and fibrinolysis seen in molar pregnancies most likely have a multifactorial pathogenesis, but the initiating causes must depend on several events taking place in the trophoblast itself and their consequences upon a very distorted intervillous blood circulation.
在14例葡萄胎患者接受任何重要治疗之前进行了凝血和纤维蛋白溶解试验，其中8例在葡萄胎排空后再次进行了检测。将结果与一组10名正常妊娠志愿者的结果进行了比较。问题病例中最常见的异常是部分凝血活酶时间缩短和凝血酶时间延长。在总共7例葡萄胎排空前后不久有完整血液学指标的病例中，最初显示血小板和纤维蛋白原显著下降。在既往子宫活动重要的病例中，最明显的血液学指标变化发生在葡萄胎排出后。这些发现提示存在一种潜在的高凝状态，纤维蛋白原周转率更高，纤维蛋白原 - 纤维蛋白降解产物水平升高，甚至在排出机制开始之前可能就已存在。得出的结论是，葡萄胎妊娠中所见的凝血和纤维蛋白溶解改变很可能有多种发病机制，但起始原因必定取决于滋养层本身发生的若干事件及其对严重扭曲的绒毛间隙血液循环的影响。
