Pathogenesis and management of peripartum coagulopathic calamities (disseminated intravascular coagulation and amniotic fluid embolism)
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...
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| Vydáno v: | Thrombosis research Ročník 131; s. S32 - S34 |
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| Hlavní autor: | |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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United States
Elsevier Ltd
01.01.2013
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| ISSN: | 0049-3848, 1879-2472, 1879-2472 |
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| Abstract | 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. |
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| AbstractList | 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. 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.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. Abstract 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. |
| Author | Levi, Marcel |
| Author_xml | – sequence: 1 givenname: Marcel surname: Levi fullname: Levi, Marcel email: m.m.levi@amc.uva.nl organization: Department of Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/23452737$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1056/NEJM199908193410807 10.1016/S1701-2163(16)35214-8 10.1097/00003246-199902000-00042 10.1111/j.1365-2044.1979.tb04862.x 10.1016/S0301-2115(00)00448-6 10.1056/NEJMoa1006221 10.1097/ALN.0b013e31821bdcfd 10.1016/j.blre.2009.04.002 10.1016/S0301-2115(97)00199-1 10.1053/beog.2001.0204 10.1016/S0029-7844(99)00004-6 10.1097/CCM.0b013e31824e6737 10.1111/j.1538-7836.2007.02767.x 10.1001/jama.1941.02820410023008 10.1111/j.1365-2141.2009.07600.x 10.1111/j.1600-0412.2012.01442.x 10.1053/beog.1999.0060 10.1016/S0049-3848(09)70013-1 10.1016/S0301-2115(02)00113-6 10.1111/j.1939-165X.2011.00369.x 10.1016/0002-9378(67)90454-1 10.1097/AOG.0b013e3181d9f629 10.1097/CCM.0b013e3182536d49 |
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| Keywords | Pregnancy Disseminated intravascular coagulation Amniotic fluid embolism Coagulation |
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| SubjectTerms | Abruptio Placentae - diagnosis Abruptio Placentae - physiopathology Amniotic Fluid - metabolism Amniotic fluid embolism Anticoagulants - therapeutic use Blood Coagulation Coagulation Disseminated intravascular coagulation Disseminated Intravascular Coagulation - physiopathology Disseminated Intravascular Coagulation - therapy Embolism, Amniotic Fluid - physiopathology Embolism, Amniotic Fluid - therapy Female Hematology, Oncology and Palliative Medicine Humans Insulin-Like Growth Factor Binding Protein 1 - metabolism Placenta - metabolism Pregnancy Pregnancy Complications, Hematologic - diagnosis Pregnancy Complications, Hematologic - physiopathology Pregnancy Complications, Hematologic - therapy Risk Factors |
| Title | Pathogenesis and management of peripartum coagulopathic calamities (disseminated intravascular coagulation and amniotic fluid embolism) |
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