{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:10:53Z","timestamp":1777497053381,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2015,7,2]],"date-time":"2015-07-02T00:00:00Z","timestamp":1435795200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clinical Hemorheology and Microcirculation"],"published-print":{"date-parts":[[2015,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>OBJECTIVE:<\/jats:bold>\n                    Patients with a history of severe obstetric complications in the\n          presence of elevated phospholipid antibodies are at high risk for recurrent obstetric\n          debacle. We report a successful immunologic treatment for prevention of HELLP-Syndrome in\n          subsequent pregnancy in a patient with elevated Phospholipid antibodies, while under\n          rheological and hemostaseological monitoring.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>METHODS:<\/jats:bold>\n                    The patient with prior severe HELLP-Syndrome at term in the presence\n          of reconfirmed elevated phospholipid antibodies in her first pregnancy received pooled\n          immunoglobulins (Sandoglobulin 3\u200ag - Novartis) intravenously for immunological treatment\n          every three weeks in addition to low molecular weight heparin (Clexane 40\u200amg\/d s.c.) and\n          Aspirin (100\u200amg\/d from 2nd trimester) during her subsequent pregnancy. Before each of 10\n          treatment cycles blood rheological parameters (Red Blood cell {RBC} aggregation stasis E0,\n          low shear E1, RBC - deformability low-, moderate-, and high shear force, plasma viscosity\n          {Pv}), as well as thrombelastometry (ROTEM) and\n                    <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                    platelet\n          function (PFA-100) for hemostaseological evaluation was performed. At the same times\n          non-invasive, physical thrombosis screening took place using impedance plethysmography\n          (Filtrass)\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>RESULTS:<\/jats:bold>\n                    During pregnancy a constant increase in PV and E1 (&gt;45\n            S\n                    <jats:sup>\u00a0\u22121<\/jats:sup>\n                    ) was accompanied by a delayed but continuous increase in RBC\n          deformability beginning at the end of the 2nd trimester. Thrombelastometry revealed a\n          continuous reduction of clot formation time (CFT; extem: 84 to 38\u200asec) and an increase in\n          maximal clot firmness (MCF; extem: 64 to 78\u200asec) after TF-induced coagulation activation\n          while MCF and CFT after contact activation (intem) was barely unchanged. Platelet\n          bleeding-time after EPI\/Coll stimulation was temporary prolonged by the onset of Aspirin\n          intake (&gt;300\u200asec) but normalized soon after 20th gestational week, while ADP\/Coll\n          stimulation revealed a trend towards prolonged bleeding times at the same time. There was\n          a strong and statistically significant inverse correlation between E1 and TF induced CFT\n            (\n                    <jats:italic toggle=\"yes\">r<\/jats:italic>\n                    \u200a=\u22120.82;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u200a=\u200a0.002) and a positive correlation\n          between E1 and TF induced MCF (\n                    <jats:italic toggle=\"yes\">r<\/jats:italic>\n                    \u200a=\u200a0.89;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u200a&lt; \u200a0.001),\n          while the correlation between E1 and contact activated CFT and MCF was weak or absent,\n          respectively. Until GW 38th routine laboratory- (Platelet-count, Haptoglobin, liver\n          enzymes) and clinical findings remained normal, without evidence of HELLP-Syndrome\n          reoccurrence or development of thrombosis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>CONCLUSIONS:<\/jats:bold>\n                    During immunotherapy in this high risk patient HELLP-Syndrome\n          did not reoccur. The aggregability of RBC was closely related with the formation speed and\n          firmness of clot after TF activated coagulation but not after contact activated\n          coagulation. At the beginning of 3rd trimester RBC aggregation remained dramatically\n          higher as compared to the normal value range of pregnant women found in a large recent\n          trial which may have been an early indicator of imminent HELLP-Syndrome.\n                  <\/jats:p>","DOI":"10.3233\/ch-151937","type":"journal-article","created":{"date-parts":[[2015,7,3]],"date-time":"2015-07-03T07:50:55Z","timestamp":1435909855000},"page":"123-131","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Rheological, hemostaseological changes during immunetherapy for prevention of          HELLP-syndrome in a patient with elevated phospholipid antibodies"],"prefix":"10.1177","volume":"60","author":[{"given":"Georg-Friedrich","family":"von Tempelhoff","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, City Hospital of\r          Aschaffenburg, Aschaffenburg, Germany"},{"name":"Institut of Coagulation Disorders in Obstetrics and\r          Gynecology, Freiherr vom Stein, Hausen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panagiotis","family":"Tsikouras","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, City Hospital of\r          Aschaffenburg, Aschaffenburg, Germany"},{"name":"Democritus University of Thrace, Department of Obstetrics and\r          Gynecology, Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Werner","family":"Rath","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University RWTH\r          Aachen, Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Velten","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, City Hospital of\r          Aschaffenburg, Aschaffenburg, Germany"},{"name":"Institut of Coagulation Disorders in Obstetrics and\r          Gynecology, Freiherr vom Stein, Hausen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Csorba","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, City Hospital of\r          Aschaffenburg, Aschaffenburg, Germany"},{"name":"Institut of Coagulation Disorders in Obstetrics and\r          Gynecology, Freiherr vom Stein, Hausen, Germany"},{"name":"Department of Obstetrics and Gynaecology, University of\r          Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,7,2]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318249ff06"},{"key":"e_1_3_2_3_2","first-page":"353","article-title":"Antiphospholipid antibodies and the antiphospholipid syndrome in systemic\n            lupus erythematosus","volume":"68","author":"Alarc\u00f3n-Segovia D","year":"1989","unstructured":"Alarc\u00f3n-SegoviaDDelez\u00e9MOriaCV1989Antiphospholipid antibodies and the antiphospholipid syndrome in systemic lupus erythematosusA prospective analysis of 500 consecutive patients, MedicineHYPERLINK \u201chttp:\/\/www.ncbi.nlm.nih.gov\/pubmed\/661\u201d (Baltimore)68353365","journal-title":"A prospective analysis of 500 consecutive patients, MedicineHYPERLINK \u201chttp:\/\/www.ncbi.nlm.nih.gov\/pubmed\/661\u201d (Baltimore)"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/PAT.0b013e32834d7bee"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-08-522623"},{"key":"e_1_3_2_6_2","first-page":"541","article-title":"The association of antiphospholipid antibodies with severe\n            preeclampsia","volume":"73","author":"Branch DW","year":"1989","unstructured":"BranchDWAndresRDigreKBRoteNSScottJR1989The association of antiphospholipid antibodies with severe preeclampsiaObstet Gynecol73541545","journal-title":"Obstet Gynecol"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(00)70500-X"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0961203310395054"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181fe02ec"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3233\/CH-2012-1571"},{"key":"e_1_3_2_11_2","first-page":"358","article-title":"Arthritis Rheum pregnancy. 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