Prenatal and peripartum management of congenital afibrinogenaemia.
We experienced three cases and four successful deliveries with congenital afibrinogenaemia and propose the following guidelines for the prenatal and peripartum management: (i) genital bleeding usually begins at 5 weeks' gestation and spontaneous abortion always occurs at 6-8 weeks' gestation without fibrinogen infusion; (ii) the fibrinogen level must be at least 0.60 g/l and, if possible, higher than 1.0 g/l during the pregnancy; (iii) the necessary amounts of fibrinogen increase as the pregnancy progresses and the preterm labour occurs; (iv) the fibrinogen level under the continuous infusion of fibrinogen during labour must be at least 1.5 g/l and, if possible, higher than 2.0 g/l to prevent placental abruption; (v) the puerperium is usually uneventful with a reduced dose of fibrinogen infusion.
Kobayashi
T
T
Department of Obstetrics and Gynaecology, Hamamatsu University School of Medicine, 3600 Handa-cho, Hamamatsu City, Shizuoka 431-3192 Japan. tkoba@hama-med.ac.jp
Kanayama
N
N
Tokunaga
N
N
Asahina
T
T
Terao
T
T
D000022:Abortion, Spontaneous / Q000517:prevention & control*; D000328:Adult; D000347:Afibrinogenemia / Q000151:congenital* / Q000188:drug therapy*; D005260:Female; D005315:Fetal Diseases / Q000188:drug therapy*; D005340:Fibrinogen / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy
D005340:Fibrinogen