Management of Pregnancy in Inherited Dysfibrinogenemia after Recurrent Miscarriage

Beitrag in einer Fachzeitschrift


Details zur Publikation

Autor(en): Zimmermann R, Peisl J, Geisen C, Koerber S, Achenbach S, Hackstein H
Zeitschrift: Transfusionsmedizin
Jahr der Veröffentlichung: 2019
Band: 9
Heftnummer: 1
Seitenbereich: 24-28
ISSN: 2191-8805
eISSN: 2191-8813


Abstract

Dysfibrinogenemia can lead to bleeding or thrombosis as well as to obstetric complications. The latter include early pregnancy loss, hemorrhage, placental abruption, and thrombosis. There are only a few case reports with treatment recommendations for pregnancy in affected women. We report on a meanwhile 34-year-old woman who had four consecutive early abortions between 2013 and 2015. At the presentation in our outpatient clinic, the patient reported a tendency to bruising, but no other bleeding and no thromboembolic events. Laboratory examinations showed a reduced Quick value, a prolonged thrombin time, a largely prolonged reptilase time, and fibrinogen concentrations of 0.67 g/l (Clauss method) and 3.87 g/l (immunoturbidimetry). The patient was diagnosed with dysfibrinogenemia. The molecular biological examination revealed the mutation c.103C>T. (p.Arg35Cys) in Exon 2 of the FGA gene (synonym A alpha 16Arg -> Cys substitution). During the fifth and sixth pregnancy, the patient was treated with a low-molecular heparin using the recommended prophylaxis dose for increased risk of thrombosis. At the same time, the patient received fibrinogen concentrate three times a week (3 x 2 g per week). Both pregnancies were uneventful. Poor pregnancy outcomes were reported in many cases if functionally active fibrinogen levels were less than 0.6 g/l (Clauss method). After the diagnosis of dysfibrinogenemia in a woman without an obvious tendency to bleed and without thromboembolic events in her history, it seems to us to be the best procedure to substitute fibrinogen and to applicate low-molecular-weight heparins at the same time to prevent bleeding, thrombosis, and pregnancy loss as well.


FAU-Autoren / FAU-Herausgeber

Achenbach, Susanne Dr. med.
Transfusionsmedizinische und Hämostaseologische Abteilung in der Chirurgischen Klinik
Hackstein, Holger Prof. Dr. med.
Professur für Transfusionsmedizin und Cell-Engineering
Zimmermann, Robert Prof. Dr.
Medizinische Fakultät


Autor(en) der externen Einrichtung(en)
Goethe-Universität Frankfurt am Main


Zitierweisen

APA:
Zimmermann, R., Peisl, J., Geisen, C., Koerber, S., Achenbach, S., & Hackstein, H. (2019). Management of Pregnancy in Inherited Dysfibrinogenemia after Recurrent Miscarriage. Transfusionsmedizin, 9(1), 24-28. https://dx.doi.org/10.1055/a-0747-7576

MLA:
Zimmermann, Robert, et al. "Management of Pregnancy in Inherited Dysfibrinogenemia after Recurrent Miscarriage." Transfusionsmedizin 9.1 (2019): 24-28.

BibTeX: 

Zuletzt aktualisiert 2019-15-04 um 10:03