Placenta percreta management in a patient with a severe congenital hypofibrinogenaemia.

Jordan Wimmer, Laurent Sattler, Agathe Herb, Mary Pontvianne, Éric Boudier, Maryse Hengen, Vincent Thuet, Olivier Feugeas, Dominique Desprez
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Abstract

The obstetrical follow-up of patients with a severe hypofibrinogenemia requires a multidisciplinary collaboration because of potential maternal-fetal complications (recurrent miscarriages, intrauterine fetal demise, post-partum hemorrhage, thrombosis). We report the obstetrical management of a multiparous patient with a severe congenital hypofibrinogenemia associated with a platelet disorder (abnormal phospholipid externalization). A therapeutic strategy based on a biweekly administration of fibrinogen concentrates associated with enoxaparin and aspirin allowed the maintenance of pregnancy. But this last one got complicated by a placenta percreta requiring a salvage hysterectomy with an appropriate hemorrhage prophylaxis.

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