S. 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