Fibrinolytic Activity in Blood Serum During Pregnancy Complicated by Hypertensive Toxemias

Abstract

The recent report by Smith and Smith 1 concerning fibrinolytic activity in the serum from pre-eclamptic and eclamptic patients and its absence in those with hypertensive disease with a superimposed pregnancy, suggests that there is a specific substance in the blood of the former groups which may be produced as a result of the toxemia. Should this prove to be true itwould give a definite indication as to the direction toward which future research concerning the etiology of these conditions should be pointed and might well be utilized as a diagnostic test in certain obscure cases in which differentiation between the 2 conditions could not easily be made. In view of the fact, however, that the same activity was demonstrated in serum taken on the first day of menstruation and in post-operative patients, it seems more likely that this is a non-specific activity related to factors other than the pre-eclampsia.

In an effort to confirm this observation and to evaluate its application as a diagnostic procedure, bloods from a group of pregnant patients were tested for fibrinolysis.

Material. The patients were all attending the prenatal clinics of the Chicago Lying-in Hospital, the normal group being seen in the general clinic and the abnormal groups in the toxemia clinic. The normal patients demonstrated no signs which could be interpreted as indicating the presence of pre-eclampsia, with the exception of 2 who showed an excessive gain in weight. Those classified as having hypertensive disease had all had elevated blood pressures throughout the present pregnancy and insome instances had had previous hypertensive pregnancies in this clinic. Those diagnosed as pre-eclampsia had an onset of the classical signs of this condition appearing late in pregnancy without demonstrable residual uponpost-partum examination. The bloods taken on the first menstrual day werefrom normal young women employed in various capacities in the hospital. Method. To 0.8 cc of the fresh test serum