Split products of fibrin in maternal serum in the perinatal period

Serum levels of split products of fibrin as an assay for intravascular coagulation or primary fibrinolysis were measured in sera of 84 women in labor, in the immediate postpartum period, and for 3 days after delivery. Split products of fibrin (SPF) were present in 6 of 29 women (21 per cent) during labor, 27 of 84 women (32 per cent) in the immediate postpartum period, and 10 per cent of 33 women 24 to 72 hours after delivery. Serial coagulation studies on 12 normal primigravidas showed that a third had SPF and/or prolonged thrombin times during delivery. Other studies showed high fibrinogen levels, high plasminogen levels, and normal euglobulin clot lysis times, ruling out primary fibrinolysis in these patients. We conclude that local intravascular coagulation is a frequent occurrence during delivery and that acquired bleeding disorders with defibrination represent the extreme of this common event.