Congenital Hypofibrinogenemia and Pregnancy, Obstetric and Hematological Management

Gilabert, J.; Regañón, Edelmiro; Vila, Virtudes; Baamonde, A.; Villa, Pia; Aznar, Justo; Galbis, M

doi:10.1159/000298813

Cited by 14 publications

(10 citation statements)

References 12 publications

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“…Post partum haemorrhage is a real danger (Ratten et al 1969; Strickland et al 1982). According to Gilabert et al (1987) a minimum fibrinogen level of 120 mg/dl is required for haemostatic protection during delivery. We gave an extra 10 gm of fibrinogen during induction to maintain a fibrinogen level above 150 mg/dl.…”

Section: Discussionmentioning

confidence: 99%

Congenital afibrinogenaemia and successful pregnancy outcome. Case report

Trehan

Fergusson

1991

BJOG

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Section: Discussionmentioning

confidence: 99%

Congenital afibrinogenaemia and successful pregnancy outcome. Case report

Trehan

Fergusson

1991

BJOG

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“…46 There are a number of case reports detailing the type of bleeding events experienced by women with bleeding disorders and they include subchorionic hemorrhage, miscarriage, placental abruption, placenta previa, and secondary or delayed postpartum bleeding. 45,47–50 …”

Section: Bleeding Disordersmentioning

confidence: 99%

Hematologic Complications of Pregnancy

Townsley

2013

Seminars in Hematology

128

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Pregnancy induces a number of physiologic changes that affect the hematologic indices, either directly or indirectly. Recognizing and treating hematologic disorders that occur during pregnancy is difficult owing to the paucity of evidence available to guide consultants. This paper specifically reviews the diagnosis and management of benign hematologic disorders occurring during pregnancy. Anemia secondary to iron deficiency is the most frequent hematologic complication and is easily treated with oral iron formulations,; however care must be taken not to miss other causes of anemia, such as sickle cell disease. Thrombocytopenia is also a common reason for consulting the hematologist and distinguishing gestational thrombocytopenia from immune thrombocytopenia (ITP), preeclampsia, HELLP syndrome, or thrombotic thrombocytopenic purpura (TTP) is essential since the treatment differs widely. Occasionally the management of mother and infant involves the expeditious recognition of neonatal alloimmune thrombocytopenia (NAIT), a condition that is responsible for severe life-threatening bleeding of the newborn. Additionally, inherited and acquired bleeding disorders affect pregnant women disproportionately and often require careful monitoring of coagulation parameters in order to prevent bleeding in the puerperium. Finally, venous thromboembolism (VTE) during pregnancy is still largely responsible for mortality during pregnancy and the diagnosis, treatment options and guidelines for prevention of VTE during pregnancy are explored.

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“…Overall, there does not appear to be a significant increase in FXI levels in these women and most of them are likely to have subnormal factor levels at term [18,19]. Similarly, haemostatic abnormalities in women with fibrinogen, prothrombin, FV or FXIII deficiency are expected to continue throughout pregnancy [3,4,10,20–24].…”

Section: Haemostatic Changes In Pregnancymentioning

confidence: 99%

Pregnancy and rare bleeding disorders

2009

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Rare bleeding disorders include deficiency of fibrinogen, prothrombin, factor V, factor VII, factor X, factor XI and factor XIII together with combined deficiency disorders, factor V+VIII deficiency, and deficiency of the vitamin K-dependent factors (factor II, VII, IX and X). They account for 3-5% of all inherited coagulation disorders. Due to their rarity, information about pregnancy complications and management is limited and mostly derived from case reports. Deficiency of fibrinogen and FXIII are both found to be strongly associated with increased risk of recurrent miscarriage and placental abruption. Factor replacement is used to reduce these risks. However, the risk of miscarriage and ante-partum complications is less clear in women with other bleeding disorders. Haemostatic abnormalities in women with rare bleeding disorders seem to persist throughout pregnancy especially if the defect is severe. Therefore women affected with these disorders are at risk of post-partum haemorrhage. The fetus can also be affected and potentially at risk of bleeding complications. Specialised multidisciplinary management is essential to minimise the potential maternal and neonatal complications and ensure an optimal outcome. This paper presents literature review for pregnancy complications in each of the rare bleeding disorders. In addition general principles for management of pregnancy, labour and delivery are discussed.

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Congenital Hypofibrinogenemia and Pregnancy, Obstetric and Hematological Management

Cited by 14 publications

References 12 publications

Congenital afibrinogenaemia and successful pregnancy outcome. Case report

Congenital afibrinogenaemia and successful pregnancy outcome. Case report

Hematologic Complications of Pregnancy

Pregnancy and rare bleeding disorders

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