Hemostasis in the perinatal period: approach to the diagnosis of coagulation disorders.
A wide range of hemostatic disorders may complicate the clinical course of the mother or fetus during pregnancy and the perinatal period. Given the potentially life-threatening implications of hemorrhage or thrombosis, it is important to evaluate these clinical emergencies with an organized approach to the diagnosis of the pertinent derangement and its etiology in order to institute corrective action promptly. Therapeutic interventions are outside the scope of this presentation; however, it is evident that an efficient and precise diagnosis is the first step toward effective, corrective action. The three elements of the hemostatic system that have been presented, blood vessels, platelets, and plasma proteins, provide a logical framework for initiating the hemostatic evaluation and interpreting screening hemostasis tests. Optimum patient management is rewarding, since many of the disorders discussed in this article are of brief duration, improving after the peripuerium. In contrast, the manifestations of hemorrhage may lead to life-long complications.
Beardsley
D S
DS
Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06510.
D001778:Blood Coagulation Disorders / Q000175:diagnosis*; D019411:Clinical Laboratory Techniques; D003937:Diagnosis, Differential; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D006487:Hemostasis; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis*; D011247:Pregnancy; D011644:Puerperal Disorders / Q000175:diagnosis*; D012016:Reference Values