Problems pertaining to obstetrical hemorrhage are of extreme clinical importance. As an integral part of the study of various properties of the blood related to obstetrical bleeding, a clinical study representing an attempt to clarify variations in platelet counts of mothers during pregnancy, at parturition, in the puerperium, with late toxemia of pregnancy, at threatened abortion and at caesarian section, of the umbilical cord blood, and of the newborn was pursued. Clot retraction rates were also studied.
1) The thrombocyte count for all blood samples obtained from nonpregnant women in normal health was 33.3±3.32±104 per cu. mm. (mean±standard error of the mean), and the clot retraction rate 50±5.1 per cent, respectively.
2) In the group of women with normal pregnancy the platelet count was 26.59±7.57×10
4to 29.02±9.12×10
4per cu. mm. on the average, the value diminshing progressively with the course of gestation, reaching the lowest level at 8 to 9 months of pregnancy, and in-creasing rapidly thereafter to rise to an average level of 37.93±11.12×10
4per cu. mm. on the sixth day of puerperium. The platelet count in these subjects became restored to the level in the nonpregnant by the thirtieth day post parturition. The pregnant women displayed clot retraction rates generally higher than those shown by the non-pregnant ; the rate for all blood samples obtained from the former was 49±9.4 per cent to 54±6.2 per cent, the trend toward increase emerged in the intermediate stage of gestation, and the rate began decreasing on the sixth puerperal day to fall to a level of 50±8.0 per cent on an average.
3) The group of neonates born by full-term delivery showed an umbilical cord arterial platelet count of 31.71±7.91×10
4per cu. mm. and an umbilical cord venous platelet count of 32.55±8.28×10
4per cu. mm., respectively. There was no evidence of difference in these counts between the sexes whereas a slightly positive correlationship was noted to exist between the mother and the newborn. The neonatal platelet count was observed to be frequently diminished on the sixth day after birth, as compared with that noted immediately upon delivery. The umbilical cord venous blood showed a clot retraction rate of 39±8.7 per cent, and the umbilical cord arterial blood a rate of 38±4.0 per cent, respectively, on the average.
4) For all blood samples drawn from mothers undergoing caesarean operation, the thrombocyte count was observed to be lowered immediately after the section, to show a tendency to recovery from the first postoperative day on, and eventually to rise above the preoperative level in the first or second week operation, followed by a gradual diminution to return to the normal level.
5) Both the maternal platelet count and clot retraction rates of the group of women seriously ill with late toxemia of pregnancy and of that of mothers slightly ill with the same disease did not differ significantly from those of women with normal gestation.
6) Neither the group of threatened abortions with favorable prognoses nor that with poor prognoses displayed significant aberrations from the group of normal pregnant subjects with respect to platelet count and clot retraction rate. In the group of threatened abortions with favorable prognoses, however, diminution of maternal platelet count was in evidence following administration of progesterone.
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