Document Detail


Extensive spontaneous retroperitoneal hemorrhage: an unusual complication of heparin anticoagulation during pregnancy.
MedLine Citation:
PMID:  10406306     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 27-year-old patient at 13 weeks' gestation maintained on subcutaneous heparinization due to hemoglobin S and hemoglobin C (SC) sickle cell disease and previous splenic vein thrombosis presented with spontaneous acute onset of severe left lower abdominal and groin pain. The pain, which radiated to the anterior aspect of the thigh, was associated with nausea and vomiting and was exacerbated by extension of the left lower extremity. The patient was hemodynamically stable, yet during the first 24 h of hospitalization a marked decrease in hematocrit from 29% to 22% occurred. Contrast computed tomography (CT) revealed an extensive abdominal-pelvic, retroperitoneal hematoma extending approximately 15 cm in length from above L5 cephalad to below the greater trochanter of the left femur caudally. The retroperitoneal hemorrhage self-tamponaded and did not require surgical management. The dosage of heparin was decreased and maintained with appropriate activated partial prothrombin (aPTT) levels. To our knowledge, this is the first report of a spontaneous retroperitoneal hemorrhage complicating heparin anticoagulation in pregnancy. Unusual hemorrhagic complications of anticoagulation therapy are discussed.
Authors:
D M Sherer; A K Dayal; B M Schwartz; R Oren; O Abulafia
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of maternal-fetal medicine     Volume:  8     ISSN:  1057-0802     ISO Abbreviation:  J Matern Fetal Med     Publication Date:    1999 Jul-Aug
Date Detail:
Created Date:  1999-08-31     Completed Date:  1999-08-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9211288     Medline TA:  J Matern Fetal Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  196-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain
Adult
Anemia, Sickle Cell / complications
Anticoagulants / adverse effects*
Female
Hematocrit
Hemoglobin, Sickle / analysis
Hemorrhage / chemically induced*
Heparin / adverse effects*
Humans
Pregnancy
Pregnancy Complications, Hematologic*
Retroperitoneal Space
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Hemoglobin, Sickle; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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