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  • Title: Retrochorionic hematoma in congenital afibrinogenemia: resolution with fibrinogen concentrate infusions.
    Author: Aygören-Pürsün E, Martinez Saguer I, Rusicke E, Louwen F, Geka F, Ivaskevicius V, Oldenburg J, Klingebiel T, Kreuz W.
    Journal: Am J Hematol; 2007 Apr; 82(4):317-20. PubMed ID: 17034026.
    Abstract:
    Without treatment, pregnancies in patients with congenital afibrinogenemia terminate in miscarriage at 5-6 weeks of gestation. Animal model studies have suggested that implantation site bleeding contributes to miscarriage in afibrinogenemia; however, retrochorionic hematoma in human congenital afibrinogenemia has not been previously observed. A patient with congenital afibrinogenemia receiving fibrinogen prophylaxis developed a retrochorionic hematoma in the first trimester. With continuous intensified fibrinogen concentrate replacement the hematoma resolved over 6 weeks, and the patient delivered a healthy infant. Median fibrinogen levels in the first trimester were 48 mg/dL and in second and third trimester 44 mg/dL. Median fibrinogen levels under 60 mg/dL may be adequate to maintain pregnancy in patients with congenital afibrinogenemia, although it is possible that higher levels might reduce the risk of hemorrhagic events.
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