子痫前期伴低纤维蛋白原血症：2 例病例报告并文献复习。
Preeclampsia complicated with hypofibrinogenemia: 2 case reports and review of the literature.
机构信息
Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, 250000, China.
出版信息
BMC Pregnancy Childbirth. 2023 Sep 1;23(1):631. doi: 10.1186/s12884-023-05965-z.
BACKGROUND
Preeclampsia complicated with hypofibrinogenemia is a rare disorder. We report two cases of severe preeclampsia complicated with hypofibrinogenemia followed by postpartum haemorrhage (PPH).
CASE
Two women diagnosed as preeclampsia and hypofibrinogenemia developed severe PPH after undergoing Cesarean sections. Besides supplement with fibrinogen concentrate and supportive treatment, the second patient got administration of heparin after delivery and bleeding was stopped. The haemorrhage in case 1 didn't disappear until an hysterectomy. The two patients both recovered and were discharged soon.
CONCLUSIONS
Severe preeclampsia patients with hypofibrinogenemia could suffer PPH. It's necessary to detect and master coagulation function. Heparin could be considered to balance hypercoagulation and hypocoagulation to avoid catastrophic haemorrhage and hysterectomy.
背景
子痫前期伴低纤维蛋白原血症是一种罕见的疾病。我们报告了两例严重子痫前期伴低纤维蛋白原血症，随后发生产后出血（PPH）的病例。
病例
两名被诊断为子痫前期和低纤维蛋白原血症的妇女在接受剖宫产术后发生严重的 PPH。除了补充纤维蛋白原浓缩物和支持治疗外，第二位患者在分娩后给予肝素治疗，出血停止。病例 1 的出血直到行子宫切除术才消失。两名患者均康复并很快出院。
结论
患有低纤维蛋白原血症的严重子痫前期患者可能发生 PPH。有必要检测和掌握凝血功能。肝素可用于平衡高凝和低凝，以避免灾难性出血和子宫切除术。
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