1/14. Complications caused by extramembranous placement of intrauterine pressure catheters.A case report is described in which the inadvertent placement of a standard intrauterine pressure catheter in a laboring woman caused partial abruptio placentae and disseminated intravascular coagulation. Altering catheter placement technique and giving attention to aspects of placement can help avoid mishaps, and awareness of possible complications can lead to earlier diagnosis with increased appropriate intervention.- - - - - - - - - - ranking = 1keywords = intravascular coagulation, intravascular, coagulation (Clic here for more details about this article) |
2/14. Coagulation changes in eclampsia: their frequency and pathogenesis.The maternal coagulation mechanism has been investigated in an effort to identify its role, if any, in the pathogenesis of eclampsia. thrombocytopenia was identified in 28 of 95 cases (29 per cent), a prolonged thrombin time in 19 of 38 (50 per cent), abnormally elevated serum fibrinogen-fibrin degradation products in two of 65 (3 per cent), and circulating fibrin monomer in one out of 20 (5 per cent). Overt hemolysis was rare (2 per cent). Thus the pattern as well as the degree of change in the maternal coagulation mechanism differed remarkably from that typical of severe abruptio placentae and of prolonged retention of a dead fetus, the classic obstetric models of fast and slow disseminated intravascular coagulation. It is concluded that the coagulation changes when present in eclampsia are effect rather than cause. Moreover, the changes may evolve primarily from platelet adherence at sites of vascular endothelial damage as the consequence of segmental vasospasm and vasodilatation rather than be triggered by the escape of thromboplastin from the placenta into the maternal circulation.- - - - - - - - - - ranking = 1.1293467986157keywords = intravascular coagulation, intravascular, coagulation (Clic here for more details about this article) |
3/14. fibrinogen Poissy II (gammaN361K): a novel dysfibrinogenemia associated with defective polymerization and peptide B release.A fibrinogen variant was identified in a pregnant patient with disseminated intravascular coagulation and abruptio placentae. This dysfibrinogen was also found in four asymptomatic members of the patient's family. Coagulation studies showed prolongation of both the thrombin and reptilase times, and discrepancy was noted between the levels of plasma fibrinogen as determined by a kinetic versus an immunological determination or light-scattering assay. Studies on purified fibrinogen revealed an impaired release of fibrinopeptide b by thrombin related to a delayed thrombin-induced fibrin polymerization. dna sequencing revealed a heterozygous T <-- A point mutation in position 9373 of the gamma-chain gene (exon 9), which substituted a K for an N at position 361.- - - - - - - - - - ranking = 1keywords = intravascular coagulation, intravascular, coagulation (Clic here for more details about this article) |
4/14. Pulmonary embolization by chorionic villi causing maternal death after a car crash.Throughout the last century, there has been a marked decline in obstetric maternal deaths, resulting in an increase in the proportion of nonobstetric deaths among pregnant women. Trauma, in particular, has become a leading cause of maternal death. We report the case of a 20-year-old primigravid woman who was involved in a motor vehicle crash at 36 weeks gestation. The woman developed abruptio placentae, followed by disseminated intravascular coagulation, adult respiratory distress syndrome, and shock, and died the day after the crash. Widespread pulmonary embolization by chorionic villi was identified at autopsy. This report discusses traumatic maternal deaths, with emphasis on the differences in injury pattern observed in pregnant trauma victims in comparison with other adults. It is important that the pathologist be aware of these problems so that an accurate cause of death can be identified in cases of maternal death after trauma. Also discussed is the relationship between trauma and placental abruption and the mechanism of death in the patient. To the authors' knowledge, this is the first reported case of extensive embolism of chorionic villi to the lungs after trauma.- - - - - - - - - - ranking = 1keywords = intravascular coagulation, intravascular, coagulation (Clic here for more details about this article) |
5/14. ritodrine therapy in the presence of chronic abruptio placentae.BACKGROUND: Betamimetic therapy is usually contraindicated for the treatment of premature labor associated with abruptio placentae. We report prolongation of a pregnancy for 7 weeks using ritodrine despite the presence of placental abruption. CASE: A 33-year-old primigravid woman presented at 25 weeks' gestation with irregular uterine contractions, vaginal bleeding, and sonographic evidence of abruptio placentae. Port wine-colored amniotic fluid was found during amniocentesis, and serial hematocrits decreased from 36 to 25%. A diagnosis of abruptio placentae was made, and because the maternal cardiovascular and fetal biophysical indices were normal, tocolytic therapy was started. Before the administration of ritodrine, the patient and her husband were given an extensive review of the risks, including blood transfusion, adult respiratory distress syndrome, disseminated intravascular coagulopathy, and maternal or fetal death. CONCLUSION: Although clinical suspicion of abruptio placentae remains a contraindication to betamimetic therapy, exceptions may be made if fetal and maternal well-being can be monitored and if a fully staffed operating room is always available for immediate cesarean delivery. The benefits of this management may outweigh the associated risks for carefully chosen, very preterm gestations.- - - - - - - - - - ranking = 0.076895626981402keywords = intravascular, coagulopathy (Clic here for more details about this article) |
6/14. A life-threatening second trimester disseminated intravascular coagulopathy with protein s deficiency.Disseminated intravascular coagulopathy (DIC) is an uncommon but serious complication of pregnancy. Placental abruption is the most common associated condition among the causes of acute obstetrical DIC. We present a case of life-threatening DIC complicating placental abruption in the second trimester of pregnancy with protein s deficiency as a triggering factor, which necessitated urgent termination of pregnancy.- - - - - - - - - - ranking = 0.38447813490701keywords = intravascular, coagulopathy (Clic here for more details about this article) |
7/14. Painless abruptio placentae associated with disseminated intravascular coagulation and syncope.abruptio placentae is a complication of pregnancy associated with significant morbidity and mortality for both fetus and mother. The presence of uterine pain and tenderness traditionally has been considered a useful criterion for distinguishing abruptio placentae from other causes of bleeding in pregnancy. We report the case of a 25-year-old woman who presented with painless abruptio placentae and coagulopathy during the second trimester. This case illustrates the importance of considering this diagnosis in pregnant patients with vaginal bleeding.- - - - - - - - - - ranking = 4.0271417834059keywords = intravascular coagulation, intravascular, coagulation, coagulopathy (Clic here for more details about this article) |
8/14. DIC and acute renal failure as a complication of abruptio placentae.Disseminated intravascular coagulopathy (DIC) is not a new concept. Almost 90 years ago De Lee reported a case of fetal coagulation disorder with abruptio placentae and described it as "temporary hemophilia." Disseminated intravascular clotting is the result of a widespread exposure of the circulating blood to procoagulant activity capable of activating fibrinolytic enzyme system converting fibrinogen into the fibrin. Fibrin may in turn cause small blood vessel occlusion resulting in tissue necrosis, and as the phenomenon occurs more often in the glomerular capillaries acute renal failure may ensue.- - - - - - - - - - ranking = 0.16976507009543keywords = intravascular, coagulation, coagulopathy (Clic here for more details about this article) |
9/14. Ocular complications of disseminated intravascular coagulation (DIC) in abruptio placentae.A 30 year old white woman presented at term with vaginal bleeding, dizziness and blurred vision due to bilateral serous retinal detachments. Extensive areas of choroidal occlusion with focal leakage of dye from the posterior retinal pigment epithelium and choroid were demonstrated by fluorescein angiography. With the diagnosis of abruptio placentae, a dead fetus and disseminated intravascular coagulation (DIC) the patient underwent removal of the uterine contents by cesarean section. DIC and retinal detachments resolved with improvement of vision, DIC, frequently observed in obstetric complications, has a tendency to occlude the posterior choroidal vessels, which often results in serous retinal detachments. In the setting of pregnancy, especially complicated late pregnancy, the occurrence of serous retinal detachments may be an early ocular sign of DIC.- - - - - - - - - - ranking = 5keywords = intravascular coagulation, intravascular, coagulation (Clic here for more details about this article) |
10/14. Fetal survival following coagulopathy at 17 weeks' gestation.Placental separation in the third trimester of pregnancy may be associated with coagulopathy, fetal distress, or intrauterine death. We report a case of vaginal bleeding due to placental separation at 17 weeks' gestation associated with disseminated intravascular coagulation. After treatment with blood, fresh frozen plasma, and fibrinogen, the pregnancy progressed uneventfully for another 12 weeks, when delivery by emergency cesarean section was performed.- - - - - - - - - - ranking = 1.1357089170297keywords = intravascular coagulation, intravascular, coagulation, coagulopathy (Clic here for more details about this article) |
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