Schroeder, Lars, Hellmund, Astrid, Gembruch, Ulrich ORCID: 0000-0001-8284-4669 and Merz, Waltraut Maria (2020). Amniotic fluid embolism-associated coagulopathy: a single-center observational study. Arch. Gynecol. Obstet., 301 (4). S. 923 - 930. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1432-0711

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Abstract

Introduction Amniotic fluid embolism (AFE) continues to be a rare, enigmatic condition with high maternal mortality. It is characterized by cardiovascular compromise, loss of consciousness or other neurologic symptoms, and coagulopathy. The latter is usually treated according to existing protocols for consumptive coagulopathy. Methods Serial analyses of a panel of hemostaseological parameters were performed in three consecutive cases of AFE that occurred at our institution. Results All mothers and neonates survived without major sequelae. Disproportionately low levels of fibrinogen and factor five, and exorbitantly elevated d-dimers were present in all cases, whereas markers of consumptive coagulopathy, platelets and antithrombin in particular, were only slightly reduced. Discussion Our results support hyperfibrinolysis as contributing factor of AFE-associated coagulopathy. We, therefore, propose a treatment algorithm which includes early use of tranexamic acid and transfusion of red blood cells and fresh frozen plasma, adding fibrinogen if hemostasis is not readily achieved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Schroeder, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hellmund, AstridUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gembruch, UlrichUNSPECIFIEDorcid.org/0000-0001-8284-4669UNSPECIFIED
Merz, Waltraut MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-339542
DOI: 10.1007/s00404-020-05466-w
Journal or Publication Title: Arch. Gynecol. Obstet.
Volume: 301
Number: 4
Page Range: S. 923 - 930
Date: 2020
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1432-0711
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
DISSEMINATED INTRAVASCULAR COAGULATION; TISSUE FACTOR TF; PROCOAGULANT PROPERTIES; INTERNATIONAL SOCIETY; MICROPARTICLES MPS; TRANEXAMIC ACID; INHIBITOR TFPI; SCORING SYSTEM; HEMOSTASIS; MANAGEMENTMultiple languages
Obstetrics & GynecologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/33954

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