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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Veröffentlicht in:Thrombosis research Jg. 131; S. S32 - S34
1. Verfasser: Levi, Marcel
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Elsevier Ltd 01.01.2013
Schlagworte:
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
Pregnancy
Disseminated intravascular coagulation
Amniotic fluid embolism
Coagulation
ISSN:0049-3848, 1879-2472, 1879-2472
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Zusammenfassung: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.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0049-3848
1879-2472
1879-2472
DOI:10.1016/S0049-3848(13)70017-3