Evaluation of Hypercoagulability in Septic Abortion

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Abstract
Soluble fibrin monomer complexes (SFMC) were determined in patients with septic abortion (body temperatures of more than 39 °C and/or chills without apparent signs of endotoxic shock), with infected abortion, with non-infected abortion and with normal pregnancies. Quantitative gel filtration (4% agarose) of β-alanine precipitated plasma samples yielded the relative (percent of total fibrinogen content) and absolute (mg/l00 ml plasma) amount of SFMC. The relative (5.5 ± 1.4%, mean ± SD) and absolute (21.5 ± 8.6 mg/l00 ml) amount of SFMC was significantly increased in patients with septic abortion compared to patients with normal pregnancies or non-infected abortion (p < 0.001). Patients with infected abortion already revealed increased levels of SFMC (4.3 ± 1.2%, 14.2 ± 6.8 mg/l00 ml) though their platelet count was still unaltered (infected abortion: 221 ± 47 × 103 platelets/mm3; septic abortion: 99 ± 36 × 103 platelets/mm3). The use of heparin in patients with septic abortion resulted in a decrease in SFMC. Chain characterization of SFMC frequently revealed a slight degradation of the α-chains probably due to fibrinolytic activity in vivo; γ-γ dimers representing inter-molecular covalent bindings were not observed. The findings are in agreement with our former assumption that patients with septic abortion have a pronounced state of hypercoagulability.