Blood coagulations studies in pregnant patients with infective hepatitis.

Coagulation studies were made on 22 pregnant women with acute infective hepatitis and on 15 normal control pregnant women in third trimester. Fourteen hapatitis patients had clinical evidence of liver failure and all of them had a haemorrhagic diathesis; none of the patients without liver failure showed clinical evidence of haemostatic defects. Coagulopathy was present in most patients, its severity being greater in those with hepatic failure. Significant alterations were observed in bleeding time, whole blood clotting time, prothrombin time, thrombin time, plasma fibrinogen and serum levels of fibrinogen degradation products. The last three disturbances were most frequent in patients with liver failure. Increased fibrinolysis and disseminated intravascular coagulation also appeared to play a contributory role, particularly in patients with hepatic failure.

Blood coagulation in patients with acute infections hepatitis in India.

Coagulation studies were performed in 61 patients of acute infective hepatitis. 18 with clinical signs of liver failure had bleeding and all succumbed. The 47 patients without liver failure showed no haemorrhagic diathesis and all of them had uneventful recovery. Though coagulopathy was present in most of the patients, the severity and frequency of coagulation defects were more in those with signs of hepatic failure. Hypofibrinogenemia, elevated serum fibrinogen degradation products and accelerated euglobulin lysis were conspicuous in patients with hepatic failure. It appears that while diminished synthesis of coagulation factors is the main basis for coagulopathy in patients without hepatic failure, additional factors like local or disseminated intravascular coagulation and increased fibrinolysis also contribute significantly to the coagulopathy in cases of liver failure.