在B型血友病携带者怀孕期间通过定期的XIX因子替代成功管理:病例报告
Saho Fujino1, Kayoko Kaneko2, Akitsu Higuchi2
1Division of Obstetrics, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan.
概括
女B型血友病携带者可能会经历严重出血,尤其是在怀孕期间. 在这些患者中,定期替代凝血因子IX对于控制出血和确保成功活产至关重要.
科学领域:
- 血液学 血液学 血液学
- 遗传学 遗传学是一种遗传学.
- 产科 产科 产科 产科 产科
背景情况:
- 血友病B是一种X相关性疾病,影响凝血因子IX.
- 女性携带者通常比男性有较轻微的出血症状.
- 在血友病携带者怀孕具有独特的出血风险.
研究的目的:
- 报告流产后,B型血友病携带者出现严重出血的情况.
- 描述在随后的怀孕期间经常出血的管理.
- 强调在孕妇携带者中进行XIX因子替代的重要性.
主要方法:
- 一个37岁的B型血友病携带者的病例报告.
- 最初的治疗包括输血和子宫动脉栓塞.
- 随后的怀孕通过定期的凝血因子IX替代物来维持~50%的活性来管理.
主要成果:
- 患者经历了流产后的严重出血,最初可以控制,但复发.
- 第九因子的替代物成功地控制了大量的出血.
- 第二次怀孕是用预防性XI因子进行的,结果是尽管有下血瘤和出血,但活产是成功的.
结论:
- 传统的产科出血治疗可能对B型血友病携带者来说不足.
- 定期的凝血因子IX替代,以活动水平为指导,对有出血史的孕妇有好处.
- 积极的因子管理可以使携带者在经常性出血发作的情况下获得成功的妊娠结果.
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