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DIC in pregnancy

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https://www.readbyqxmd.com/read/27868334/consensus-on-the-standardization-of-terminology-in-thrombotic-thrombocytopenic-purpura-and-related-thrombotic-microangiopathies
#1
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
BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS) are two important acute conditions to diagnose. Thrombotic Microangiopathy is a broad pathophysiological process that leads to microangiopathic hemolytic anemia, thrombocytopenia and involves capillary and small vessel platelet aggregates. The most common cause being disseminated intravascular coagulation (DIC), which may be differentiated by abnormal coagulation. Clinically, a number of conditions present with microangiopathic hemolytic anemia and thrombocytopenia (MAHAT), including cancer, infection, transplantation, drugs, autoimmune disease and pre-eclampsia and HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count) syndrome in pregnancy...
November 21, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27861597/comparison-of-two-diagnostic-scores-of-disseminated-intravascular-coagulation-in-pregnant-women-admitted-to-the-icu
#2
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
https://www.readbyqxmd.com/read/27599183/hemolysis-elevated-liver-enzymes-and-low-platelet-syndrome-outcomes-for-patients-admitted-to-intensive-care-at-a-tertiary-referral-hospital
#3
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
https://www.readbyqxmd.com/read/27589544/use-of-uterine-artery-embolization-to%C3%A2-prevent-peripartum-hemorrhage-of-placental-abruption-with-fetal-demise-severe-dic
#4
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
https://www.readbyqxmd.com/read/27545958/clinical-evaluation-of-balloon-occlusion-of-the-lower-abdominal-aorta-in-patients-with-placenta-previa-and-previous-cesarean-section-a-retrospective-study-on-43-cases
#5
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)...
August 18, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27424373/acute-fatty-liver-of-pregnancy-analysis-on-the-diagnosis-and-treatment-of-15-cases
#6
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
https://www.readbyqxmd.com/read/27181089/disseminated-intravascular-coagulation-in-the-hellp-syndrome-how-much-do-we-really-know
#7
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
https://www.readbyqxmd.com/read/26775691/challenges-in-psychopharmacology-a-drug-information-centre-perspective
#8
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
https://www.readbyqxmd.com/read/26657845/interleukin-23-regulates-the-functions-of-human-decidual-immune-cells-during-early-pregnancy
#9
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
https://www.readbyqxmd.com/read/26639719/mild-anemia-as-a-protective-factor-against-pregnancy-loss
#10
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
https://www.readbyqxmd.com/read/26444122/disseminated-intravascular-coagulation-syndromes-in-obstetrics
#11
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
https://www.readbyqxmd.com/read/26313391/pregnancy-and-delivery-in-leyden-m%C3%A3-bius-muscular-dystrophy-case-report
#12
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
https://www.readbyqxmd.com/read/26251142/-diagnosis-and-treatment-of-microangiopathic-hemolytic-anemia
#13
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
https://www.readbyqxmd.com/read/26108251/hepatosplenic-t-cell-lymphoma-with-aberrant-expression-of-serum-%C3%AE-hcg-a-case-report
#14
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
https://www.readbyqxmd.com/read/26105943/pp086-severe-hypertensive-complications-in-pregnancy-two-years-study-2011-2012
#15
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
https://www.readbyqxmd.com/read/26105939/pp085-hypertensive-complication-in-pregnancy-hellp-syndrome-one-year-study-2012
#16
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
https://www.readbyqxmd.com/read/26105382/pp059-angiogenic-factors-and-risk-of-preeclampsia-related-adverse-outcomes-in-twin-pregnancies
#17
S Rana, M Hacker, A Merport, S Salahuddin, S Verlohren, F Perschel, S A Karumanchi
INTRODUCTION: Preeclampsia (PE) is a pregnancy specific hypertensive disorder with an overall incidence of 5-8% among all pregnancies.Incidence of PE in twins is about 2-4 fold higher compared to singletons.Angiogenic factors are implicated in pathogenesis of PE and related adverse outcomes.No studies exist evaluating angiogenic factor assessment in twin pregnancies complicated by PE or use of these proteins for prediction of PE-related adverse outcomes in twins. OBJECTIVES: Our objective was to evaluate whether angiogenic factor levels correlate with the diagnosis of PE and predict adverse maternal and perinatal outcomes in women with twin pregnancy...
July 2012: Pregnancy Hypertension
https://www.readbyqxmd.com/read/26023604/placenta-percreta-in-first-trimester-leading-to-disseminated-intravascular-coagulopathy-dic-a-rare-case-report
#18
Charu Lata Bansal, Jyotsana Gupta, Deepti Asthana, Ankit Kayal
Placenta percreta is the most severe form of abnormal placental attachment. It is a variant of placenta accreta in which chorionic villi penetrate the entire thickness of the myometrium through the uterine serosa and may involve the adjacent structures. Literature review shows very few cases encountered during the first trimester of pregnancy. A-20-year-old woman with previous one cesarean section presented with continuous vaginal bleeding beginning after incomplete abortion at seven weeks and six days period of gestation for which she underwent dilatation and curettage...
April 2015: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/26012157/-disseminated-intravascular-coagulation-and-acute-kidney-injury-requiring-renal-replacement-therapy-after-diagnostic-amniocentesis
#19
Marina Ratković, Nikolina Bašić-Jukić, Branka Gledović, Danilo Radunović
Disseminated intravascular coagulation (DIC) is a very rare complication of amniocentesis. We present a case of a 33-year-old patient who developed DIC with acute respiratory distress syndrome and acute kidney injury after diagnostic amniocentesis. The patient required replacement of renal function for 59 days with continuous venovenous hemodiafiltration and later with hemodialysis. She was treated with heparin, fresh frozen plasma, platelets and cryoprecipitate. Her condition was further complicated with the development of intracranial hematoma...
April 2014: Acta Medica Croatica: C̆asopis Hravatske Akademije Medicinskih Znanosti
https://www.readbyqxmd.com/read/25948773/management-of-hypertension-in-pregnancy
#20
Nurike S Mudjari, Nur Samsu
Hypertension-related maternal mortality reaches 16% when it is compared to other causes of maternal mortality such as sepsis, bleeding or abortus. Pregnant women with hypertension disorder are at increased risk for experiencing numerous complications including disseminated intravascular coagulation (DIC), cerebral hemorrhage, liver dysfunction and acute renal failure; while to the fetus, it may cause intrauterine growth retardation, prematurity and perinatal mortality. Hypertension in pregnancy should be managed appropriately to reduce maternal and fetal morbidity and mortality rate, i...
January 2015: Acta Medica Indonesiana
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