Prenatal and Peripartum Management of Patients with Hypofibrinogenemia Resulted in Two Successful Deliveries

Teraoka, Yuko; Mizumoto, Hiroshi; Oshima, Kiyohiro; Urabe, Satoshi; Tanaka, Nobukazu; Kudo, Yoshiki

doi:10.1155/2017/9427359

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…Pregnancy with congenital hypofibrinogenemia is a rare but a high-risk condition. Currently, only a few reports are available on pregnancy associated with hypofibrinogenemia; since 1961, only 10 cases of this disorder during pregnancy have been described [ 4 – 11 ]. Owing to the rarity of the disease and the absences of randomized controlled studies, management of pregnancy with hypofibrinogenemia is challenging.…”

Section: Introductionmentioning

confidence: 99%

Congenital hypofibrinogenemia in pregnancy

Cai

Liang

Yang

et al. 2018

Blood Coagulation &Amp; Fibrinolysis

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To investigate the obstetrical outcomes and plasma concentrations of fibrinogen (FIB) in patients with congenital hypofibrinogenemia in pregnancy, 11 cases with hypofibrinogenemia in pregnancy were analyzed retrospectively. The demographic database, bleeding tendency, plasma levels of FIB throughout pregnancy, peripartum management, as well as, maternal and neonatal outcomes were assessed. FIB levels in our patients remained relatively stable throughout the pregnancy. The mean FIB levels during the three trimesters of pregnancy were 75.7 ± 43.9 (25–148), 67.6 ± 33.7 (22–146), and 77.9 ± 29.2 (32–148) mg/dl, respectively. Twelve full-term deliveries were achieved using FIB replacement therapy only on the group of labor or cesarean deliveries. The postpartum courses were unremarkable without hemorrhagic or thrombotic complications. Five out of twelve neonates were diagnosed with low levels of FIB in 6 weeks after birth. The pregnancies were uneventful with no signs of bleeding in these congenital hypofibrinogenemia women. Vaginal delivery, instead of cesarean section, may be the superior choice. Successful maternal and neonatal outcomes could be achieved by accurate monitoring of the FIB levels and adequate supportive therapy.

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Section: Introductionmentioning

confidence: 99%

Congenital hypofibrinogenemia in pregnancy

Cai

Liang

Yang

et al. 2018

Blood Coagulation &Amp; Fibrinolysis

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“…A previous study has shown the association between Oligohydramnios and preterm risk [ 37 ]. Also Coagulation disorder (Fibrinogen, L_3255-7) is a known risk factor for preterm delivery [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

Analysis of risk factors progression of preterm delivery using electronic health records

et al. 2022

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Background Preterm deliveries have many negative health implications on both mother and child. Identifying the population level factors that increase the risk of preterm deliveries is an important step in the direction of mitigating the impact and reducing the frequency of occurrence of preterm deliveries. The purpose of this work is to identify preterm delivery risk factors and their progression throughout the pregnancy from a large collection of Electronic Health Records (EHR). Results The study cohort includes about 60,000 deliveries in the USA with the complete medical history from EHR for diagnoses, medications and procedures. We propose a temporal analysis of risk factors by estimating and comparing risk ratios and variable importance at different time points prior to the delivery event. We selected the following time points before delivery: 0, 12 and 24 week(s) of gestation. We did so by conducting a retrospective cohort study of patient history for a selected set of mothers who delivered preterm and a control group of mothers that delivered full-term. We analyzed the extracted data using logistic regression and random forests models. The results of our analyses showed that the highest risk ratio and variable importance corresponds to history of previous preterm delivery. Other risk factors were identified, some of which are consistent with those that are reported in the literature, others need further investigation. Conclusions The comparative analysis of the risk factors at different time points showed that risk factors in the early pregnancy related to patient history and chronic condition, while the risk factors in late pregnancy are specific to the current pregnancy. Our analysis unifies several previously reported studies on preterm risk factors. It also gives important insights on the changes of risk factors in the course of pregnancy. The code used for data analysis will be made available on github.

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“…There are more than 100 fibrinogen mutations that have been associated with hypofibrinogenaemia. 7 Hypofibrinogenaemia could be: a) mild (fibrinogen levels > 1 g/L): asymptomatic, excessive bleeding can occur after injuries, surgery or delivery; b) moderate (fibrinogen levels between 0.1-1 g/L): bleedings can be spontaneous or caused by injuries, surgery, or delivery; c) severe (undetectable clot): spontaneous, severe, and even life-threatening bleeding may occur. 8 Dysfibrinogenaemia results in abnormal fibrinogen function.…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary approach to management of hypofibrinogenaemia in pregnancy: A case report

Simeonova-Krstevska¹,

Todorovska²,

Makarovska-Bojadjieva³

et al. 2020

Scripta Medica

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Inherited fibrinogen disorders introduce risk for recurrent abortions, sub-chorionic haematoma, placental abruption and postpartum haemorrhage. This is a case report of a successful pregnancy outcome in a 37-year old woman with hypofibrinogenaemia. She was referred to a coagulation test in the first trimester because of history of preeclampsia and HELLP syndrome in previous pregnancy. Hypofibrinogenaemia was diagnosed with fibrinogen level of 0.7 g/L. During the pregnancy she was regularly monitored for fibrinogen levels and multiple cryoprecipitate concentrates were given. She delivered at 39th gestation week, with elective caesarean section under general anaesthesia. There was one episode of postpartum haemorrhage treated with 2 units of red blood cells, repeated infusions of cryoprecipitate to obtain the level of fibrinogen of 2 g/L. She was discharged on the 6th postpartum day in a good condition. In these disorders levels of fibrinogen should be higher than 1 g/L during pregnancy or 2 g/L in case of caesarean section for successful prenatal and peripartal management.

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Prenatal and Peripartum Management of Patients with Hypofibrinogenemia Resulted in Two Successful Deliveries

Cited by 3 publications

References 7 publications

Congenital hypofibrinogenemia in pregnancy

Congenital hypofibrinogenemia in pregnancy

Analysis of risk factors progression of preterm delivery using electronic health records

Multidisciplinary approach to management of hypofibrinogenaemia in pregnancy: A case report

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