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Congenital hypofibrinogenemia in pregnancy: a report of 11 cases

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.
Source: Blood Coagulation and Fibrinolysis - Category: Hematology Tags: Original Articles Source Type: research

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PMID: 29451162 [PubMed - in process]
Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
Abstract Background: Pravastatin (Pra) exerts protective effects on preeclampsia. Preeclampsia is a multifactorial and pathogenic pathway syndrome. The present study compared the effects of Pra on clinical manifestations of preeclampsia in different pathogenic pathways. Methods: Two different preeclampsia-like mouse models used in this study were generated with Nω-nitro-L-arginine methyl ester (L-NAME) and used lipopolysaccharide (LPS) from day 7 of gestation, respectively. Pra treatment was administered on day 2 after the models were established in each group (L-NAME + Pra, LPS + Pra, and Control + Pra...
Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
A suspect was charged after three people, including a pregnant woman, sustained minor injuries in the crash. The authorities would not comment on a motive.
Source: NYT Health - Category: Consumer Health News Authors: Tags: Planned Parenthood Federation of America East Orange (NJ) New Jersey Traffic Accidents and Safety Health Insurance and Managed Care Robberies and Thefts Assaults Essex County Correctional Facility Essex County (NJ) Alcius, Marckles Source Type: news
A suspect was charged after three people, including a pregnant woman, sustained minor injuries in the crash. The authorities would not comment on a motive.
Source: NYT Health - Category: Consumer Health News Authors: Tags: Planned Parenthood Federation of America East Orange (NJ) New Jersey Traffic Accidents and Safety Health Insurance and Managed Care Robberies and Thefts Assaults Essex County Correctional Facility Essex County (NJ) Alcius, Marckles Source Type: news
ConclusionDysfibrinogenemia patients without personal or family history of bleeding and thromboembolic events, do not need specific therapeutic intervention.
Source: Journal of Clinical Laboratory Analysis - Category: Laboratory Medicine Authors: Tags: BRIEF REPORT Source Type: research
ConclusionThe results of this initiative should help clinicians in the difficult management of patients with congenital fibrinogen disorders.
Source: Haemophilia - Category: Hematology Authors: Tags: Original Article Source Type: research
Publication date: June–July 2016 Source:Medicina Intensiva (English Edition), Volume 40, Issue 5 Author(s): E. Guasch, F. Gilsanz Massive obstetric hemorrhage is a major cause of maternal mortality and morbidity worldwide. It is defined (among others) as the loss of >2500ml of blood, and is associated to a need for admission to critical care and/or hysterectomy. The relative hemodilution and high cardiac output found in normal pregnancy allows substantial bleeding before a drop in hemoglobin and/or hematocrit can be identified. Some comorbidities associated with pregnancy can contribute to the occurrence of ca...
Source: Medicina Intensiva - Category: Intensive Care Source Type: research
We present a case of mild FXIII deficiency and concurrent hypofibrinogenemia manifested by recurrent postpartum hemorrhage, menorrhagia, and miscarriage. Mutational analysis identified a previously unreported heterozygous mutation of the FXIIIA subunit (p.Trp315Arg). No mutation was noted in the fibrinogen gene. FXIII levels decreased approximately 50% from nonpregnant levels to their nadir during labor, whereas fibrinogen levels rose approximately 1.5-fold from decreased nonpregnant levels to their peak at the time of labor. This case illustrates the course of mild FXIII and fibrinogen deficiencies during pregnancy, labor...
Source: Blood Coagulation and Fibrinolysis - Category: Hematology Tags: Case Reports Source Type: research
Semin Thromb HemostDOI: 10.1055/s-0036-1571339Congenital fibrinogen disorders are rare diseases affecting either the quantity (afibrinogenemia and hypofibrinogenemia) or the quality (dysfibrinogenemia) or both (hypodysfibrinogenemia) of plasmatic fibrinogen. Afibrinogenemia is often diagnosed at birth following prolonged umbilical cord bleeding and is characterized by spontaneous bleeding in all tissues, while hypofibrinogenemic patients are more often asymptomatic. Spontaneous spleen ruptures, painful bone cysts, cardiovascular events, and intrahepatic inclusions can complicate the clinical course of patients with quantit...
Source: Seminars in Thrombosis and Hemostasis - Category: Hematology Authors: Source Type: research
Conclusions Simultaneous determination of fibrinogen concentrations using the Clauss method, prothrombin time-derived method, and immunoturbidimetry as well as measurement of the thrombin time, reptilase time, prothrombin time, activated partial thromboplastin time and so on can effectively distinguish dysfibrinogenemia from other diseases. Special treatment of asymptomatic dysfibrinogenemia is not needed during pregnancy or surgery in the absence of bleeding or thrombotic events in the patient's personal or family history.
Source: Clinica Chimica Acta - Category: Laboratory Medicine Source Type: research
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