Pregnancy-related thrombosis in a woman with congenital afibrinogenemia: a report of two successful pregnancies.
We managed two pregnancies in a woman with congenital afibrinogenemia with increasing amounts of cryoprecipitate to achieve a pre-infusion fibrinogen level of 60 mg/dL. The first pregnancy resulted in placental abruption at 36 weeks, in spite of recent cryoprecipitate infusion. Both placentas showed infarction. Post-partum ovarian and renal vein thromboses complicated the second pregnancy. Mean FVIII (344%) and vWF Antigen (323%) were elevated prior to cryoprecipitate infusion, with mean post-infusion levels of 367% and 363%. The clearance of fibrinogen after cryoprecipitate infusion increased during the course of pregnancy. A paradoxical prothrombotic state with embolization may play a role in the observed complications of pregnancy.
Roqué
H
H
Department of Obstetrics and Gynecology, New York University Medical Center, 550 First Avenue, New York, NY 10016, USA.
Stephenson
C
C
Lee
M J
MJ
Funai
E F
EF
Popiolek
D
D
Kim
E
E
Hart
D
D
D000347:Afibrinogenemia / Q000150:complications / Q000151:congenital*; D005169:Factor VIII / Q000032:analysis / Q000627:therapeutic use; D005260:Female; D005340:Fibrinogen / Q000032:analysis / Q000627:therapeutic use; D006801:Humans; D007668:Kidney / Q000098:blood supply; D010053:Ovary / Q000098:blood supply; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011250:Pregnancy Complications, Hematologic; D011256:Pregnancy Outcome; D012008:Recurrence; D020246:Venous Thrombosis / Q000150:complications*; D014841:von Willebrand Factor / Q000032:analysis
C026912:cryoprecipitate coagulum; D014841:von Willebrand Factor; D005169:Factor VIII; D005340:Fibrinogen