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Review on coagulation in trophoblastic disease
Annals of the Academy of Medicine, Singapore
|October 1, 1982
Summary
Hydatidiform molar pregnancies exhibit enhanced coagulation, posing risks during evacuation. Coagulation screening is vital to prevent life-threatening bleeding complications in these trophoblastic disorders.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Reproductive Medicine
Background:
- Abnormal pregnancy states like eclampsia are known to cause hemostasis problems.
- Coagulation defects in hydatidiform molar pregnancies are often overlooked due to rarity.
- Enhanced coagulation is a consistent finding in hydatidiform molar pregnancies.
Purpose of the Study:
- To emphasize the significance of defective hemostasis in hydatidiform molar pregnancies.
- To investigate the occurrence and implications of coagulation disorders in this trophoblastic disease.
- To highlight the necessity of coagulation screening in hydatidiform moles.
Main Methods:
- Review of clinical course and postmortem findings.
- Hematological studies on patients with hydatidiform moles.
- Analysis of placental proteins involved in coagulation and fibrinolysis.
Main Results:
- Evidence confirms enhanced coagulation in all hydatidiform molar pregnancies.
- Secondary fibrinolysis intensifies during mole evacuation, potentially worsening coagulopathy.
- Intravascular coagulation can become irreversible during evacuation if not corrected pre-procedure.
Conclusions:
- Coagulation screening tests are essential for all hydatidiform moles, as vaginal bleeding is an unreliable indicator of coagulopathy.
- Placental proteins may contribute to the etiology of coagulation disorders and serve as prognostic markers for malignancy.
- Prompt correction of coagulation defects before evacuation is critical to prevent maternal mortality.