title: [Treatment of a pregnant patient after multiple trauma: rare combination with thrombotic thrombocytopenic purpura].
abstract: Multiple trauma during pregnancy is a relatively rare situation which poses a great challenge for the team in charge of treatment. A concomitant disease, such as thrombotic thrombocytopenic purpura (TTP) with thrombocytic coagulopathy increases the complexity of the treatment problems. This article describes the case of a 36-year-old pregnant woman referred to this hospital suffering from multiple trauma with severe liver rupture. Stabilization was achieved after an emergency Caesarean section and packing of the liver. Recurrent massive bleeding from the liver occurred after depacking and was treated successfully with recombinant factor VIIa. The concomitant TTP was treated by transfusion of fresh frozen plasma and corticosteroids. Rapid initiation of therapy was the goal to achieve hemostasis and prevent aggravation of the coagulation disorder and an unfavourable outcome despite severe thrombocytopenia.
authors: Klinik für Anästhesiologie und Operative Intensivmedizin, Ortenauklinikum Lahr-Ettenheim, Klostenstr. 19, 77933 Lahr, Deutschland. ehaffner@gmx.de
authors: E
authors: E
authors: Haffner
authors: U
authors: U
authors: Pietsch
authors: T
authors: T
authors: Fösel
authors: W
authors: W
authors: Lindemann
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D002585:Cesarean Section; D003422:Critical Care; D004632:Emergency Medical Services; D015942:Factor VIIa / Q000627:therapeutic use; D005260:Female; D006470:Hemorrhage / Q000628:therapy; D006487:Hemostasis; D006801:Humans; D008020:Life Support Care; D008099:Liver / Q000293:injuries / Q000601:surgery; D009104:Multiple Trauma / Q000150:complications / Q000601:surgery / Q000628:therapy*; D010949:Plasma; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy*; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications / Q000628:therapy*; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D011994:Recombinant Proteins; D015942:Factor VIIa
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