Document Detail


Pathogenesis and management of peripartum coagulopathic calamities (disseminated intravascular coagulation and amniotic fluid embolism).
MedLine Citation:
PMID:  23452737     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Acute coagulopathic peripartum calamities are relatively rare but contribute importantly to maternal morbidity and mortality in the Western world. Abruptio placenta, amniotic fluid embolism, and retained fetal or placental material may lead to fulminant intravascular activation of coagulation which results in thromboembolic complications and consumption coagulopathy causing severe hemorrhage. The central underlying pathophysiological pathway in the coagulopathy associated with these syndromes is the occurrence of tissue factor, released from the placenta and amniotic fluid, in the circulation, in combination with low levels of physiological anticoagulant factors during pregnancy. The diagnosis of DIC may be made trough conventional composite scoring systems employing routine coagulation tests, whereas for the diagnosis of amniotic fluid embolism measurement of insulin like growth factor binding protein-1 seems promising. Therapy is aimed at removing the precipitating factor combined with supportive adjunctive treatment options.
Authors:
Marcel Levi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Thrombosis research     Volume:  131 Suppl 1     ISSN:  1879-2472     ISO Abbreviation:  Thromb. Res.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-03-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S32-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: m.m.levi@amc.uva.nl.
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