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Hemostatic variables in patients with intrauterine fetal death
T Duchinski1, D Pisarek-Miedzinska, M Szczepanski
1Department of Gynecology and Obstetrics, Medical Center of Postgraduate Education, Warsaw, Poland.
Insights
Hemostatic disturbances are rare in intrauterine fetal death (IFD). Significant changes like fibrinogenopenia and thrombocytopenia only appear after four weeks of fetal retention, indicating a delayed systemic hemostasis deterioration.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Reproductive Medicine
Background:
- Intrauterine fetal death (IFD) can potentially lead to maternal hemostatic complications.
- Understanding the timing and nature of these disturbances is crucial for clinical management.
Purpose of the Study:
- To evaluate the incidence and characteristics of hemostatic disturbances in women experiencing intrauterine fetal death.
Main Methods:
- Retrospective review of medical records for 41 patients with IFD.
- Analysis of hemostatic variables and documented bleeding complications.
- Inclusion of patients with multiple pregnancies.
Main Results:
- Most patients with IFD showed normal coagulation test results, with only elevated platelet counts observed.
- One case, a twin pregnancy with a single fetal demise, demonstrated abnormalities after 4 weeks.
- This specific case developed increased fibrin degradation products, fibrin monomers, fibrinogenopenia, and thrombocytopenia.
Conclusions:
- Systemic hemostatic deterioration in IFD is infrequent and typically manifests after a prolonged period (over 4 weeks) of fetal retention.
- Key indicators of this deterioration include low fibrinogen (fibrinogenopenia) and low platelet counts (thrombocytopenia).
Objective:
To assess the occurrence of hemostatic disturbances in patients with intrauterine fetal death (IFD).
Method:
The occurrence of abnormal results of hemostatic variables and of bleeding complications was noted from the medical records of 41 patients with IFD, 6 of whom had a multiple pregnancy.
Result:
Apart from the increased platelet count, results of blood coagulation tests in all except one patient with IFD did not differ from normal values. This patient, who had a twin pregnancy with one dead fetus, had an increase in fibrin degradation products and fibrin monomers 4 weeks after IFD and fibrinogenopenia and thrombocytopenia 2 weeks later.
Conclusion:
The deterioration of systemic hemostasis in women with IFD is rare and only occurs after 4 weeks of dead fetus retention; the main signs of this deterioration are fibrinogenopenia and thrombocytopenia.