Antemortem Thrombosis in Stillbirths, Neonates, Infants and Children, with Particular Reference to Disseminated Fibrin Thrombo-Embolism

Boyd, James Ferguson (1960) Antemortem Thrombosis in Stillbirths, Neonates, Infants and Children, with Particular Reference to Disseminated Fibrin Thrombo-Embolism. MD thesis, University of Glasgow.

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This thesis reports the results of histological investigations into the occurrence, incidence, and distribution by organs of thrombosis in stillborn infants, neonatal deaths and deaths among infants and children. Sixty-eight cases showing antemortem thrombosis are recorded and a further three cases of thrombosis in relation to malignant tumours are illustrated. Particular attention has been paid to stillbirth and neonatal deaths, which tend to exhibit thrombi which are rich in fibrin. This finding is illustrated well, and can be compared with the findings in infants and children showing antemortem thrombi. These latter tend to be mixed thrombi, containing corpuscular elements as well as fibrin. The high incidence of hepatic thrombi particularly in stillborn infants, but also to a lesser degree among early neonatal deaths, (i.e. infants living less than 48 hours), suggests that the clotting process was initiated in the placenta. These two conclusions, namely (1) that the clotting episode is initiated in the placenta, and (2) that the thrombi are rich in fibrin, lend support to Schneider's hypothesis regarding " obstetric shock" in the mother, which states that the clinical picture of "obstetric shock can be explained by the sudden release of thromboplastin of decidual or placental origin (these two tissues being extremely rich in this substance), into the maternal circulation. The results reported in this thesis suggest that placental thromboplastin is also capable of entering the foetal circulation. The reported cases illustrate various aspects of thrombosis and embolism in several origans particularly in the liver, lung, adrenal gland, brain, and spleen and the results of the temporary bleeding state which can ensue. The fact that this can occur without any apparent maternal upset suggests that less thromboplastin is necessary to cause foetal death than maternal death, and this would be expected. A survey of fibrinogen levels has been carried out in over 400 infants, and the results suggest that one of the essential features of the histological picture illustrated in the cases recorded is that these babies possess a high fibrinogen level before the clotting episode occurs.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Keywords: Medicine, Physiology, Histology
Date of Award: 1960
Depositing User: Enlighten Team
Unique ID: glathesis:1960-79357
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 05 Mar 2020 10:37
Last Modified: 05 Mar 2020 10:37

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