title: Prenatal and Peripartum Management of Patients with Hypofibrinogenemia Resulted in Two Successful Deliveries.
abstract: Fibrinogen is an essential agent involved in maintaining pregnancy and coagulation. Since inherited fibrinogen disorders introduce greater risks for conditions such as placental abruption and postpartum hemorrhage, careful prenatal and perinatal management is essential for this patient population. We report two cases of successful deliveries in patients with hypofibrinogenemia. Case 1 is of a 26-year-old (gravida 1, para 1) woman. The patient's fibrinogen level increased spontaneously to higher than 300 mg/dL during pregnancy, without treatment. She delivered at week 38 of gestation, with no complications. Case 2 is of a 30-year-old (gravida 3, para 1) woman. We performed repeated infusions of fibrinogen to maintain the level higher than 100 mg/dL during pregnancy and at least 200 mg/dL in the perioperative period; the patient delivered a healthy infant. We identified a new mutation, Hiroshima I (γ278Tyr→His). It is important to maintain appropriate fibrinogen levels in cases of inherited fibrinogen disorders for successful prenatal and peripartum management.
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Biomedical Science and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Yuko
authors.identifier: 0000-0002-4077-8525
authors.initials: Y
authors.lastname: Teraoka
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Biomedical Science and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyoshi
authors.affiliation: Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
authors.forename: Kumi
authors.initials: K
authors.lastname: Oshima
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Biomedical Science and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Urabe
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Biomedical Science and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Norifumi
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Biomedical Science and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Kudo