[Gestosis, thrombophilia and pulmonary embolism in a primipara with twin pregnancy].
This is a case report on a course of gemini-pregnancy complicated by gestosis, recurrent submassive pulmonary embolism and discordant growth of the hypotrophic twins. It is concluded from this report that: 1. the AT-III-deficiency in gestosis can be caused by loss and consumption; 2. due to decrease below a critical AT-III-level the coagulation-fibrinolysis system tends to decompensate, reflected in a disseminated intravascular coagulation and/or a pulmonary embolism. The tendency consists particularly in immobilisation and stasis; 3. the daily determination of AT III, better of TAT-complex and D-dimer, the daily clinical examination regarding signs of thrombosis and in cases of heparinization the measurement of PTT several times daily, are necessary to avoid or recognise disorders, of the coagulation-fibrinolysis-system at an early stage. 4. The increased consumption in coagulation systems can be avoided by AT-III substitution and correct heparinisation. 5. In cases of risk of pulmonary embolisation in pregnancy a cava filter should be temporarily implanted. The filter must be changed every 3 days, if it is required for a longer period. 6. In high-risk pregnancy the check for factors of thrombophilia is a basic diagnostic procedure.
Engelmann
L
L
Abteilung für Intensivmedizin, Universität Leipzig.
Ruckhäberle
K E
KE
Engelmann
B
B
Scheel
H
H
Vogtmann
C
C
Deckert
F
F
D000328:Adult; D000990:Antithrombin III / Q000008:administration & dosage; D020152:Antithrombin III Deficiency; D001780:Blood Coagulation Tests; D002585:Cesarean Section; D003131:Combined Modality Therapy; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood* / Q000628:therapy; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007231:Infant, Newborn; D008274:Magnesium / Q000627:therapeutic use; D010949:Plasma; D011225:Pre-Eclampsia / Q000097:blood* / Q000628:therapy; D011247:Pregnancy; D011272:Pregnancy, Multiple; D011655:Pulmonary Embolism / Q000097:blood* / Q000628:therapy; D015145:Tocolysis; D014427:Twins; D016306:Vena Cava Filters
D000990:Antithrombin III; D006493:Heparin; D008274:Magnesium
Gestose, Thrombophilie und Lungenembolie bei einer Primipara mit Zwillingsschwangerschaft.