重度先天性低纤维蛋白原血症患者percreta胎盘的处理。

Jordan Wimmer, Laurent Sattler, Agathe Herb, Mary Pontvianne, Éric Boudier, Maryse Hengen, Vincent Thuet, Olivier Feugeas, Dominique Desprez
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引用次数: 0

摘要

严重低纤维蛋白原血症患者的产科随访需要多学科合作,因为潜在的母胎并发症(复发性流产、宫内胎儿死亡、产后出血、血栓形成)。我们报告了一位患有严重先天性低纤维蛋白原血症并伴有血小板紊乱(异常磷脂外化)的多产患者的产科管理。基于两周给予纤维蛋白原浓缩物联合依诺肝素和阿司匹林的治疗策略可以维持妊娠。但最后一个因为percreta胎盘而变得复杂需要抢救性子宫切除术和适当的出血预防。
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Placenta percreta management in a patient with a severe congenital hypofibrinogenaemia.

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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