Human Reproduction, Vol 12, 891-895, Copyright © 1997 by Oxford University Press
H Kodama, S Takeda, J Fukuda, H Miya, Y Shimizu, M Murata and T Tanaka
The aim of this study was to evaluate status of plasma kinin system in
patients with ovarian hyperstimulation syndrome (OHSS), in order to
investigate whether activation of the plasma kinin system correlates with
increased blood coagulability. In the first part of the study,
concentrations of plasma prekallikrein (PK) in OHSS cycles (n = 13) were
monitored from the day of human chorionic gonadotrophin (HCG)
administration to the mid-luteal phase, and were compared with those of
control cycles (n = 17). The average value of PK in OHSS cycles began to
decrease on day 8, and by day 10 was significantly lower than that of
control cycles (86 +/- 6 versus 106 +/- 4%, P <0.01). The time course of
changes in PK concentration correlated well with the clinical condition of
OHSS patients. In the second part of the study, we obtained data from 26
patients who were hospitalized because of severe OHSS, to investigate the
correlation between PK and other haemostatic markers. OHSS patients with
severe PK reduction (<80% normal, n = 9) demonstrated significantly
higher values of plasma thrombin- antithrombin III and plasmin-alpha2
antiplasmin, and more severe haemoconcentration, compared to those OHSS
patients who had no reduction in PK (n = 17). In conclusion, our data
suggest that activation of the plasma kinin system occurs specifically and
occasionally in OHSS patients, and is associated with increased blood
coagulability. Thus, when an OHSS patient demonstrates a low value of
plasma PK, more careful management is required to prevent thromboembolic
complications.
ARTICLES
Activation of plasma kinin system correlates with severe coagulation disorders in patients with ovarian hyperstimulation syndrome
Department of Obstetrics and Gynecology, Akita University School of Medicine, Hondo, Japan.
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