In the Federal Republic of Germany fresh-frozen plasma (FFP) is still the most important therapeutic agent for acquired coagulation disorders. However, thawing by waterbath (WB) requires about 30 minutes, which is too slow in emergency situations and carries the risk of bacterial contamination of the FFP. There are conflicting data about the use of microwaves for thawing. Therefore, we examined a new microwave oven (MWO; 2450 +/- 50 MHz), which was developed with our cooperation and allows thawing of FFP in 5 minutes, heating FFP to a surface temperature of 21.5 degrees C. A shaking WB (30 min, 37 degrees C) was also used in parallel for comparison. We measured activated partial thromboplastin time (aPTT), nonactivated PTT (NaPTT), fibrinogen, factors VIII:C, X, and XI, fibrinopeptide A, beta-thromboglobulin (beta-TG), thrombin-AT III-complexes, factor VIII-related antigen, C3c, C4, and the plasticizer di(2-ethylhexyl)phthalate (DEHP) in 84 units of FFP as paired samples from 42 double aphereses. Immediately after thawing there was no significant difference in the coagulation test results of FFP with low-cell contamination, regardless of the thawing procedure. Two hours later, after storage at room temperature, FFP thawed by MWO showed even less change than that thawed by WB (NaPTT, p less than 0.01; FX, p less than 0.01). The differences became more evident in comparison with FFP with higher cell contamination and could be observed immediately after thawing (FVIII:C p less than 0.001; FXI, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

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[Rapidly progressing thrombocytopenia as a threatening form of pre-eclampsia].

Atypical courses of pregnancy-induced hypertension (PIH) have been reported quite frequently during the last time. They include prepartal coagulation disorders with slight or missing typical symptoms of PIH. In cases of quickly increasing thrombocytopenia during the last trimenon, in company with elevated liver enzymes, PIH must always be taken into account. We give a case report about a nearly asymptomatic secundigravid woman who developed low platelet counts (8,000 platelets/microliter) within a few hours, which later was confirmed to be severe preeclampsia. Transient and moderate thrombocytopenia down to 50,000 platelets/microliter caused by PIH may first be treated conservatively. Progredient symptoms should lead to an early delivery, as neonatal mortality in such cases is high. We give a review about current literature which reflects on differential diagnosis, pathogenesis and therapy of this disease.

Adult↗