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DIC in pregnancy

Offer Erez
During a women's life cycle, pregnancy is a period in which she is at risk for hemorrhagic events and obstetrical syndromes that may develop into disseminated intravascular coagulation (DIC). This life-threatening condition is a complication of obstetrical and non-obstetrical causes including: (1) acute peripartum hemorrhage (uterine atony, cervical and vaginal lacerations, and uterine rupture); (2) placental abruption; (3) Pre-eclampsia/HELLP syndrome; (4) retained stillbirth; (5) sepsis; (6) amniotic fluid embolism; and (7) acute fatty liver of pregnancy...
March 2017: Thrombosis Research
Z Y Chen, L Zhao, Asiyan Nusilati, D Zhao, M Zhou, X M Zhang
Objective: To assess the indication and safety of surgical resection of the pregnancy by hysterotomy (SRPH) and hysterectomy for cesarean scar pregnancy (CSP). Methods: A retrospective study of women with CSP was conducted at the Women's Hospital, School of Medicine, Zhejiang University, from Jan. 2003 to Mar. 2016. The women underwent SRPH (SRPH group, n=35) and hysterectomy (Hysterectomy group, n=14) were included. The gestational age (GA), size of gestational mass(GM), level of serum β-hCG, previous treatments and clinical outcomes were analyzed...
February 25, 2017: Zhonghua Fu Chan Ke za Zhi
Y Wen, B Yang, Q Huang, Y Liu
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is associated with variable predisposing risk factors including preeclampsia and eclampsia since it proposed. However, studies of large case series focusing on pregnancy-related PRES are still limited. We performed a large retrospective study of patients with pregnancy-related PRES admitted to our institution. METHODS: This was a single-center, 2010-2015 retrospective cohort study of patients with pregnancy-related PRES who underwent neuroimaging via magnetic resonance imaging or computerized tomography from mainland China...
February 2, 2017: Irish Journal of Medical Science
Lv-Yin Huang, Yu Yang, Ping He, Dong-Zhi Li
We present prenatal diagnosis and chromosomal microarray analysis (CMA) of 9q34.3 microdeletion in a foetus with an increased nuchal translucency (NT). Conventional G-banding analysis showed a de novo translocation: 45, XX, dic (9;13)(q34;p13). CMA revealed a 3.6 Mb 9q34.3 microdeletion encompassing an OMIM gene of EHMT1 consistent with the diagnosis of Kleefstra syndrome and 9q subtelomeric deletion syndrome. We suggest an application of CMA at prenatal diagnosis in pregnancies with increased NT and an apparent balanced translocation on conventional karyotype...
December 14, 2016: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
M Scully, S Cataland, P Coppo, J de la Rubia, K D Friedman, J Kremer Hovinga, B Lämmle, M Matsumoto, K Pavenski, E Sadler, R Sarode, H Wu
Essentials An international collaboration provides a consensus for clinical definitions. This concerns thrombotic microangiopathies and thrombotic thrombocytopenic purpura (TTP). The consensus defines diagnosis, disease monitoring and response to treatment. Requirements for ADAMTS-13 are given. SUMMARY: Background Thrombotic thrombocytopenic purpura (TTP) and hemolytic-uremic syndrome (HUS) are two important acute conditions to diagnose. Thrombotic microangiopathy (TMA) is a broad pathophysiologic process that leads to microangiopathic hemolytic anemia and thrombocytopenia, and involves capillary and small-vessel platelet aggregates...
February 2017: Journal of Thrombosis and Haemostasis: JTH
Marie Jonard, Anne Sophie Ducloy-Bouthors, François Fourrier
OBJECTIVE: To compare the validity of two previously published diagnostic scores of disseminated intravascular coagulation (DIC) in pregnant women admitted to ICU for an acute thrombotic or hemorrhagic complication of delivery and postpartum. METHODS: This was a population based retrospective study of 154 patients admitted to ICU for severe delivery and postpartum complications in a University Hospital. A recently published score (adapted to physiological changes of pregnancy and based on three components: platelet count, prothrombin time difference and fibrinogen) was compared to the International Society for Thrombosis and Hemostasis (ISTH) score (based on four components: platelet count, fibrinogen, prothrombin time, and fibrin related marker)...
2016: PloS One
Ender Gedik, Neslihan Yücel, Taylan Sahin, Erdinc Koca, Yusuf Ziya Colak, Turkan Togal
PURPOSE: The aim was to assess outcomes for pregnancies in which hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome develops and the patient requires transfer for critical care. MATERIALS AND METHODS: The cases of women with HELLP syndrome who delivered at our tertiary center or surrounding hospitals and were admitted to the intensive care between January 2007 and July 2012 were retrospectively analyzed. Results were compared for the surviving and non-surviving patients...
September 6, 2016: Hypertension in Pregnancy
E Latif, S Adam, B Rungruang, A Al-Hendy, M P Diamond, E Rotem, J Cannell, P C Browne
Uterine artery embolization (UAE) is typically not indicated in the pre-operative management of pregnancies with a live fetus, because risk of fetal death from reduced uteroplacental blood flow. However, pre-operative UAE in pregnancies with a fetal demise poses no fetal risk, and may offer maternal benefits. Patients with placental abruption resulting in fetal demise are at high-risk for developing disseminated intravascular coagulation (DIC), which could have devastating complications such as peri-operative hemorrhage and death...
September 16, 2016: Journal of Neonatal-perinatal Medicine
Manru Chen, Lan Xie
BACKGROUND: This study investigated the efficacy of balloon occlusion of the lower abdominal aorta in cesarean section surgery for the patients with placenta previa and previous cesarean section. METHODS: The patients who had placenta previa and underwent cesarean section (CS) were evaluated. The patients treated with CS to terminate the pregnancy were used as control group (23 cases); the patients treated with the preset abdominal aorta balloon before CS was taken as study group (20 cases)...
October 2016: International Journal of Surgery
Guoyan Liu, Xiaobin Shang, Bibo Yuan, Cha Han, Yingmei Wang
OBJECTIVE: To describe our experience with the diagnosis and management of acute fatty liver of pregnancy (AFLP). STUDY DESIGN: The medical records of pregnant women with AFLP were reviewed for symptoms, laboratory findings, treatment, and maternal and fetal outcomes during a 10-year period between January 2003 and December 2013. RESULTS: During the study period 15 women had AFLP as their discharge diagnosis. The mean gestational age at onset was 36 ± 1 weeks...
May 2016: Journal of Reproductive Medicine
Kjell Haram, Jan Helge Mortensen, Salvatore Andrea Mastrolia, Offer Erez
The rate of disseminated intravascular coagulation (DIC) during pregnancy varies among nations from 0.03% to 0.35%. The existing reports suggest dissimilarity in the underlying mechanisms leading to DIC during gestation. While in developing countries preeclampsia and the HELLP syndrome are prevalent causes of DIC, the leading causes in the developed countries are placental abruption and postpartum hemorrhage. In different cohort studies, DIC is reported in about 12-14% of women with preeclampsia. Nevertheless, it has been suggested that in most cases these women also had a HELLP syndrome and that the occurrence of DIC in women who had only preeclampsia without manifestations of the HELLP syndrome is rare...
June 8, 2016: Journal of Maternal-fetal & Neonatal Medicine
J Schjøtt
WHAT IS KNOWN AND OBJECTIVE: Questions about psychotropic drugs are frequently submitted to drug information centres (DICs). Twenty years' experience from Norwegian DICs was used to identify particular challenges in responding to those questions. COMMENT: Questions about psychopharmacological therapy are usually patient-related and are often difficult to answer. Frequent questions about psychotropic drugs come from experienced senior physicians in disciplines like psychiatry, geriatrics, general practice and neurology...
February 2016: Journal of Clinical Pharmacy and Therapeutics
Jun-Ying Cai, Mu-Jun Li
BACKGROUND: This study investigated the effects of interleukin 23 (IL-23) on the production of cytokines (IL-1, IL-4, IL-10, and IL-17), the differentiation of Treg/Th17 and STAT3 (i.e., signal transducer and activator of transcription 3) in human decidual immune cells (DICs) during early pregnancy. METHODS: DICs were treated with recombinant human IL-23 and an antibody against IL-23 subunit p19. The differentiation of Treg and Th17 cells was detected by flow cytometry...
January 15, 2016: Biochemical and Biophysical Research Communications
L O Buzyan
BACKGROUND: Iron deficiency anemia is traditionally considered to be a pathological condition during pregnancy. According to the standards, prescription of iron supplements to pregnant women is required at hemoglobin levels of 110 g/l and lower. Numerous studies at different periods showed the relationship of anemia and premature birth [5], preeclampsia [1], low birth-weight [2]. Meanwhile, physiological hemodilution carries in pregnancy an important adaptive function. It is well known, that in the second half of pregnancy physiological hypercoagulability develops (increased activity of the plasma clotting factors, platelet aggregation, decreased activity and blood concentrations of physiological anticoagulants) aimed at implementing adequate hemostasis in labor...
2015: International Journal of Risk & Safety in Medicine
F Gary Cunningham, David B Nelson
Disseminated intravascular coagulation (DIC) is a syndrome that can be initiated by a myriad of medical, surgical, and obstetric disorders. Also known as consumptive coagulopathy, DIC is a common contributor to maternal morbidity and mortality and is associated with up to 25% of maternal deaths. The etiopathogenesis of DIC is complex and currently thought to be initiated by tissue factor or thromboplastin, which is released from trophoblastic or fetal tissue, or maternal decidua or endothelium. Tissue factor activates the coagulation sequence to cause fibrin clotting and its dissolution by the fibrinolysin system...
November 2015: Obstetrics and Gynecology
Blanka Vavrinkova, Tomas Binder
Leyden-Möbius muscular dystrophy is an autosomal recessive hereditary disease of unknown aetiology; it is a congenital disorder of protein metabolism primarily affecting proximal muscle groups leading to progressive muscular dystrophy. It later spreads to the muscles of the pelvic floor and lower extremities. The estimated incidence is 1:200,000. This paper describe a case of pregnancy and delivery in woman with progressive Leyden-Moebius muscular dystrophy. Cesarean section was performed due to progression of the underlying disease...
2015: Neuro Endocrinology Letters
Eriko Morishita
"Microangiopathic hemolytic anemia (MAHA)" is now used to designate any hemolytic anemia related to RBC fragmentation, occurring in association with small vessel disease. In DIC, RBC fragmentation is thought to result from the deposition of fibrin or platelets within the microvasculature. The term "thrombotic microangiopathy (TMA)" is also used to describe syndromes characterized by MAHA, thrombocytopenia, and thrombotic lesions in small blood vessels. The most prominent diagnoses associated with TMA are thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS)...
July 2015: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Andrea Bellodi, Giulia Rivoli, Eleonora Arboscello, Giuseppe Fornarini, Giulio Fraternali Orcioni, Daniele Avenoso, Maurizio Miglino, Riccardo Ghio
BACKGROUND: Peripheral T-cell lymphomas (PTCL) represent a heterogeneous group of hematologic malignancies frequently presenting at advanced stage of diagnosis. METHODS: We report a case of PTCL with an uncommon and aggressive onset with disseminated intravascular coagulation (DIC). RESULTS: Laboratory findings revealed an aberrant expression of β subunit of human chorionic gonadotropin (β-HCG). Other than for determination of pregnancy, β-HCG is regularly found as a tumor marker in germ cell tumors with trophoblastic differentiation and its aberrant expression has been reported in the literature in other neoplastic conditions only in the context of case reports...
November 2015: Tumori
Mariana Miranda, Bruna Ambrosio, Rui Gomes, Teresa Matos, Isabel Santos, Antonia Nazaré
INTRODUCTION: There are major hypertensive disorders related to pregnancy-preeclampsia,eclampsia and HELLP syndrome. These women are at an increased risk for placental abruption,renal failure, cerebral hemorrhage,hepatic failure/rupture,pulmonary edema, DIC and of long-term cardiovascular disease. OBJECTIVES: Study the incidence, risk factors, maternal/fetal outcome of hypertensive complications that determined Intensive Care Unit admission. METHODS: A retrospective study of admissions in Intensive Care Unit for preeclampsia, HELLP syndrome and eclampsia in 2011-2012...
April 2013: Pregnancy Hypertension
Mariana Miranda, Bruna Ambrosio, Rui Gomes, Isabel Santos, Teresa Matos, Antonia Nazare
INTRODUCTION: HELLP syndrome is characterized by hemolysis with a microangiopathic blood smear, elevated liver enzymes, and low platelet count. It develops in 10-20% of women with severe preeclampsia/eclampsia. The syndrome is associated with maternal morbidities - DIC, renal failure, pulmonary edema and hepatic hematoma/rupture. Some need transfusions and others require laparotomies for intraabdominal bleeding. OBJECTIVES: Study the incidence and related risk factors of HELLP syndrome in Pregnancy, as well as the maternal/fetal outcome...
April 2013: Pregnancy Hypertension
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