Document Detail


Treatment of patients with dysfibrinogenemia and a history of abortions during pregnancy.
MedLine Citation:
PMID:  19357502     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Dysfibrinogenemia is caused by a variety of structural abnormalities in the fibrinogen molecule, which results in a tendency for bleeding and thrombosis as well as obstetric complications. The obstetric complications of dysfibrinogenemia include first-trimester pregnancy loss, hemorrhage, placental abruption, and thrombosis. We conducted a retrospective study of four cases of dysfibrinogenemic patients from one family (fibrinogen Frankfurt III) with a history of recurrent pregnancy loss and who were treated with fibrinogen concentrates. One patient had three consecutive abortions in the 6th, 7th and 11th week of pregnancy. The underlying fibrinogen gene mutation was Aalpha R16C, two propositae being homophenotyic and two heterophenotypic. The median age was 30.5 years (28-39 years). The median level of fibrinogen (Clauss) was 29 mg/dl (range less than 10-51 mg/dl, normal: 150-450 mg/dl), the median level of fibrinogen according to Schulz was in the normal range at 180 mg/dl (range 180-300 mg/dl). The reptilase time was prolonged to 55 s (median, normal: -20 s). Fibrinogen was administered from the beginning of the pregnancy until delivery. In three out of four patients, abortions could be avoided by continuous administration of fibrinogen concentrates commencing as early as possible during the pregnancy in order to achieve fibrinogen plasma concentrations (Clauss) over 100 mg/dl. For the prophylaxis of thrombotic events, low-molecular heparin at a dosage of 40-60 IE/kg was administered postpartum for 14 days.
Authors:
Wolfgang Miesbach; Dennis Galanakis; Inge Scharrer
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis     Volume:  20     ISSN:  1473-5733     ISO Abbreviation:  Blood Coagul. Fibrinolysis     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-22     Completed Date:  2009-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102551     Medline TA:  Blood Coagul Fibrinolysis     Country:  England    
Other Details:
Languages:  eng     Pagination:  366-70     Citation Subset:  IM    
Affiliation:
Medical Clinic III, Institute of Transfusion Medicine, Goethe University, Frankfurt, Germany. Wolfgang.Miesbach@kgu.de
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MeSH Terms
Descriptor/Qualifier:
Abortion, Habitual / drug therapy*,  etiology,  prevention & control
Abruptio Placentae / etiology
Adult
Afibrinogenemia / complications,  drug therapy*,  genetics
Enoxaparin / therapeutic use
Female
Fibrinogen / analysis,  therapeutic use*
Fibrinogens, Abnormal / genetics*
Hemorrhage / prevention & control
Humans
Infant, Newborn
Phenotype
Pregnancy
Pregnancy Complications, Hematologic / drug therapy*,  genetics
Pregnancy Trimester, First
Prothrombin Time
Puerperal Disorders / prevention & control
Retrospective Studies
Thrombin Time
Thromboembolism / prevention & control
Thrombosis / drug therapy,  etiology
Chemical
Reg. No./Substance:
0/Enoxaparin; 0/Fibrinogens, Abnormal; 0/fibrinogen Frankfurt III, human; 9001-32-5/Fibrinogen

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


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