Coagulopathy and bleeding in the parturient patient. Recent information has helped in the identification of individuals at special risk.
Normal pregnancy is characterized by a hypercoaguable state that may progress to large or small vessel thrombosis and in some situations terminate in gross bleeding, due to consumption and lysis of clotting factors. Recent information concerning alterations in the factors that control normal clotting has helped in the identification of individuals at special risk for clotting and bleeding problems. At the present time, transfusion support is limited to unfractionated or semi-fractionated blood products. As knowledge is advanced, recombinant blood derivatives that will eliminate the risk of transmission of disease in the transfusion management of bleeding patients will emerge. In many patients consumption and lysis of clotting proteins occurs in catastrophic situations. In these situations the good clinical judgement of the obstetrician is of paramount importance. In order for the obstetrician to exercise this judgement most effectively, there must be good lines of communication among the clinicians involved in the patient's care and prompt, responsive support from the coagulation laboratory and the transfusion service.
Crowley
J P
JP
D001780:Blood Coagulation Tests; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000209:etiology*; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000209:etiology*; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology*