Document Detail

Spontaneous resolution of hypofibrinogenemia in a triplet gestation associated with second trimester in utero death of two fetuses.
MedLine Citation:
PMID:  8267810     Owner:  NLM     Status:  MEDLINE    
Multiple gestations are increasing in frequency secondary to assisted reproductive technologies; therefore, it will become increasingly important to know how to manage a multiple pregnancy in which an in utero fetal death has occurred. This case report describes the spontaneous resolution of maternal hypofibrinogenemia associated with the deaths of two fetuses in a triplet gestation. A 29-year-old woman with a triplet gestation had in utero death of two monoamniotic fetuses between 15 and 17 weeks' gestation. Maternal plasma fibrinogen levels were obtained weekly and were initially in the normal range for pregnancy. At 31 weeks' gestation, the fibrinogen level decreased to 239 mg/dl and reached a nadir of 150 mg/dl 11 days later. Although the patient received no treatment, her fibrinogen level increased to 307 mg/dl over the next 4 days and then remained above 260 mg/dl for the rest of her pregnancy. At 35 weeks' gestation, a healthy 2090 gm female was delivered. The infant is alive and well and developing normally. When there is an in utero death of one fetus of a multiple gestation in the second or early third trimester, some authors advocate heparinization to reverse maternal coagulopathy; others describe spontaneous resolution of hypofibrinogenemia. The role of heparin in treating hypofibrinogenemia remains unclear. Hypofibrinogenemia may resolve spontaneously without exposing the patient to the potentially serious risks associated with heparin therapy.
A G Mitra; N C Chescheir; R C Cefalo; B S Tatum
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of perinatology     Volume:  10     ISSN:  0735-1631     ISO Abbreviation:  Am J Perinatol     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1994-01-31     Completed Date:  1994-01-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  448-9     Citation Subset:  IM    
University of North Carolina School of Medicine, Department of Obstetrics and Gynecology, Chapel Hill, NC 27599-7570.
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MeSH Terms
Fetal Death*
Fibrinogen / analysis*
Pregnancy Complications, Hematologic / blood*
Pregnancy Trimester, Second
Pregnancy, Multiple / blood*
Remission, Spontaneous
Reg. No./Substance:

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