Skip to main content
Hauptrubriken
Zeitschriften PflegeKolleg Akademie Hebammen Bücher Kongresse & Live-Webinare
Social Media - Folgen Sie uns!
Instagram Facebook Instagram Hebammen
Service
Jobbörse Web-App Kundenservice Info & Hilfe
Fokus-Themen
Chronisch-entzündliche Darmerkrankung COVID-19-Update Diabetes Hautpflege Klima & Gesundheit Hygiene Intensivpflege Kardiologische Pflege Mobilisation Nachhaltigkeit Nierenerkrankungen Obstipation Onkologische Pflege Palliativpflege Schmerz Sucht in der Pflege Vielfalt, Gleichberechtigung und Inklusion
Erweiterte Suche
Anmelden
nach oben
Erschienen in:
Präimplantation, Implantation und Plazentation Kapitel lesen Erstes Kapitel lesen

2016 | OriginalPaper | Buchkapitel

42. Gerinnungsstörungen in der Geburtshilfe

verfasst von : Werner Rath, Frauke Bergmann

Erschienen in: Die Geburtshilfe

Verlag: Springer Berlin Heidelberg

Einloggen, um Zugang zu erhalten

Zusammenfassung

Peripartale Blutungskomplikationen sind seltene, aber möglicherweise letale Komplikationen. Um sie zu beherrschen, sollte das geburtshilfliche Team vorbereitet sein. Das Antizipieren von Risikofaktoren, das rechtzeitige Erkennen einer angeborenen oder erworbenen Blutungsstörung und ihr Management sind zwingende Voraussetzungen. Dieses Kapitel beschreibt die wichtigsten, klinisch relevanten Störungen, die mit schweren Blutungen sub- oder postpartal assoziiert sein können. Hierzu zählen die Verlust- (Verdünnungs-) sowie die Verbrauchskoagulopathie (DIC), die erworbenen Thrombopenien infolge Autoimmunthrombozytopenie oder TTP/HUS (TTP = thrombotisch-thrombozytopenische Purpura, HUS = hämolytisch-urämisches Syndrom) sowie das von-Willebrand-Syndrom (vWS), der Konduktorinnenstatus für die Hämophilie A oder B und der FVII-Mangel.
Vorheriges Kapitel Pathologie der Plazentarperiode
Nächstes Kapitel Anästhesie und Analgesie in der Geburtshilfe
Literatur
Al Zirqi I, Vangen S, Forsen L, Stray-Pedersen B (2008) Prevalence and risk factors of severe obstetric haemorrhage. BJOG 115:1265–1272CrossRefPubMed
Arulkumaran S, Mavrides E, Penney GC (2009) RCOG green-top guideline No. 52
BÄK (2008) Querschnittsleitlinien zur Therapie von Blutungskomponenten und Plasmaderivaten, 4. Aufl., zuletzt geändert Januar 2011, ISBN 978-3-7691-1269-6
Bell SF, Rayment R, Collin PW (2010) The use of fibrinogen concentrate to correct hypofibrinogenaemia rapidly during obstetric haemorrhage. Int J Obstet Anesth 19:218–223CrossRefPubMed
Benson MD (2012) Current concepts of immunology and diagnosis in amniotic fluid embolism. Clin Dev Immunol 946576
Bergmann F (2013) Schwangerschaftsbedingt erhöhte Thromboseneigung. In: Barthels M (Hrsg) Das Gerinnungskompendium. Thieme, Stuttgart/New York, S 291–300
Bick RL, Frenkel EP, Baher WF, Sarode R (2006) Hematological complications in obstetrics, pregnancy, and gynecology. Cambridge University Press, Cambridge/New York/MelbourneCrossRef
Boer K, den Hollander JA, Meijers CM, Levi M (2007) Tissue factor-dependent blood coagulation is enhanced following delivery irrespective of the mode of delivery. J Thromb Haemost 5:2415–2420CrossRefPubMed
Bollinger D, Szalami F, Molinaro RJ (2009) Finding the optimal concentration range for fibrinogen replacement after severe haemodilution: an in vitro model. Br J Anaesth 102:793–799CrossRef
Budde U, Schneppenheim R (2008) Thrombotische-thrombozytopenische Purpura. Pädiat Prax 72:619–637
Castaman G, Tosetto A, Rodeghiero F (2010) Pregnancy and delivery in women with von Willebrand’s disease and different von Willebrand factor mutations. Haematologica 95:963–969CrossRefPubMed
Charbit B, Mandelbrot L, Samain E, PPH Study Group (2007) The decrease of fibrinogen is an early predictor of the severity of postpartum hemorrhage. J Thromb Haemost 5:266–273CrossRefPubMed
Chee YL, Townend J, Crowther M et al (2012) Assessment of von Willebrand disease as a risk factor for primary postpartum haemorrhage. Haemophilia 18:593–597CrossRefPubMed
Chi C, Kadir RA (2012) Inherited bleeding disorders in pregnancy. Best Pract Res Clin Obstet Gynaecol 26:103–117CrossRefPubMed
Clark SL, Hankins GD, Dudley DA, Dildy GA, Porter TF (1995) Amniotic fluid embolism: analysis of the national registry. Am J Obstet Gynecol 172:1155
Collins NF, Bloor M, Mc Donnell NJ (2013) Hyperfibrinolysis diagnosed by rotational thromboelastometry in a case of suspected amniotic fluid embolism. Int J Obstet Anesth 22:71–76CrossRefPubMed
Conde-Agudelo A, Romero R (2009) Amniotic fluid embolism: an evidence-based review. AJOG 201:445.e1–445.e9CrossRef
Cortet M, Deneaux-Tharaux C, Dupont C (2012) Association between fibrinogen level and severity of postpartum hemorrhage: secondary analysis of a prospective trial. Br J Anaesth 108:984–989CrossRefPubMed
de Lange NH, Lancé MI, de Grool R (2012) Obstetric hemorrhage and coagulation: an update Thromboelastography, and conventional coagulation tests in the diagnosis and prediction of postpartum hemorrhage. Obstet Gynecol Surv 67:426–435CrossRefPubMed
de Lloyd L, Bovington R, Kaya A (2011) Standard haemostatic tests following major obstetric haemorrhage. Int J Obstet Anesth 20:135–141CrossRefPubMed
de Wee EM, Knol HM, Mauser-Bunschoten EP et al (2011) Gynaecological and obstetric bleeding in moderate and severe von Willebrand disease. Thromb Haemost 106:885–892CrossRefPubMed
Dean LS, Rogers RP, Harley FA, Hood DD (2012) Case scenario: amniotic fluid embolism. Anesthesiology 116:186–192CrossRefPubMed
Fakhouri F, Roumenina L, Provot F et al (2010) Pregnancy-associated hemolytic uremic syndrome revisited in the era of complement gene mutations. J Am Soc Nephrol 21:857–867CrossRef
Faridi A, Rath W (1996) Differenzialdiagnose des HELLP-syndroms. Z Geburtshilfe Neonatol 200:88PubMed
Federici AB (2006) Diagnosis of inherited von Willebrand disease: a clinical perspective. Semin Thromb Hemost 32:555–565CrossRefPubMed
Franchini M (2006) Haemostasis and pregnancy. Thromb Haemost 95:401–413PubMed
George JN (2010) How I treat patients with thrombotic thrombocytopenic purpura. Blood 116:4060–4069CrossRefPubMed
Habek D (2008) Delivery course of macerated stillborn fetuses in the third trimester. Fetal Diagn Ther 24:42–46CrossRefPubMed
Hall DR (2009) Abruptio placentae and disseminated intravascular coagulopathy. Semin Perinatol 33:189–195CrossRefPubMed
Heilmann L, Rath W, Pollow K (2007) Hemostatic abnormalities in patients with severe preeclampsia. Clin Appl Thromb Hemost 13:285–291CrossRefPubMed
Heim MU, Hellstern P (2010) Neue (Querschnitt-) Leitlinie der Bundesärztekammer für die Hämotherapie mit gefrorenem Frischplasma. Der Anästhesist 59:80–85CrossRef
Heyl W, Rath W (1999) Intrauteriner Fruchttod. In: Rath W, Heilmann L (Hrsg) Gerinnungsstörungen in Gynäkologie und Geburtshilfe. Thieme, Stuttgart/New York
Hofer S, Heindl B, Meister FC, Maul H, Martin E, Sohn C, Weigand MA (2008) Blutungen während Schwangerschaft und Geburt, schwangerschaftsbedingte hämostaseologische Veränderungen – Therapieempfehlungen. Gynakologe 42:55–69CrossRef
Huissoud C, Carrabin N, Benchaib M, Fontaine O, Levrat A, Massignon D et al (2009) Coagulation assessment by rotation thrombelastometry in normal pregnancy. Thromb Haemost 101:755–761PubMed
Huq FY, Kadir RA (2011) Management of pregnancy. Labour and delivery in women with inherited bleeding disorders. Haemophilia 17(Suppl 1):20–30CrossRefPubMed
James AH, Jamison MC (2007) Bleeding events and other complications during pregnancy and childbirth in women with von Willebrand disease. J Thromb Haemost 5:1165–1169CrossRefPubMed
Kadir RA, Davies J (2013) Hemostatic disorders in women. J Thromb Haemost 11(Suppl 1):170–179CrossRefPubMed
Kawaguchi S, Yamada T, Takeda M et al (2013) Changes in D-Dimer levels in pregnant women according to gestational week. Pregnancy Hypertens 3:172–177PubMed
Keeney S, Bowen D, Cumming A, Enayat S, Goodere A, Hill M (2008) The molecular analysis of von Willebrand disease: a guideline from the UK Haemophilia Centre Doctors’ Organization Haemophilia Genetics Laboratory Network. Haemophilia 14:1099–1111CrossRefPubMed
Knight M, Tufnell D, Brocklehurst P, Spark P, Kurincreek JU, On behalf of the UK Obstetric Surveillance System (2010) Incidence and risk factors of amniotic fluid embolism. Obstet Gynecol 115:910–917CrossRefPubMed
Koyama S, Tomimatsu T, Kanagawa T et al (2012) Reliable predictors of neonatal immune thrombocytopenia in pregnant women with idiopathic thrombocytopenic purpura. Am J Hematol 87:15–21CrossRefPubMed
Laffan MA, Lester W, O’Donnell JS et al (2014) The diagnosis and management of von Willebrand disease: a united Kingdom Haemophilia Centre Doctors Organization guideline approved by the British Commitee for Standards in Haematology. Br J Haematol 167:453–465CrossRefPubMedPubMedCentral
Lee CA, Chi C, Pavord SR, Boton-Meggs HB, Pollard D, Kadir A (2006) The obstetric and gynaecological management of women with inherited bleeding disorders-review with guidelines produced by a task force of UK Haemophilia Centre Doctors’ Organization. Haemophilia 12:301–336CrossRefPubMed
Lefkou E, Hunt BI (2012) Bleeding disorders in pregnancy. Obstet Gynaecol Reprod Med 22:339–346CrossRef
Levi M (2009) Disseminated intravascular coagulation (DIC) in pregnancy and the peri-partum period. Thromb Res 123(Suppl 2):63–64CrossRef
Levi M, Toh CH, Thachil J, Watson HG (2009) Guidelines for the diagnosis and management of disseminated intravascular coagulation. Br J Haematol 146:24–33CrossRef
Lier H, Rath W (2011) Aktuelle interdisziplinäre Handlungsempfehlungen bei schwerer peri-(post-)partaler Blutungen (PPH). Geburtsh Frauenheilk 71:577–588CrossRef
Mathieu B, Jacobs N, Mahieu S, Naelaerts K, Vartessen F, Weyler J et al (2007) Haemostatic changes and aequired activated protein C resistance in normal pregnancy. Blood Coagul Fibrinolysis 18:685–688CrossRef
McCrae KR (2010) Thrombocytopenia in pregnancy. Hematology 397–402.
Pacheco LD, Costantine MM, Saede GR et al (2010) von Willebrand disease and pregnancy: a practical approach for the diagnosis and treatment. AJOG. doi:10.1016/j.ajog2010.02.036
Peitsidis P, Kadir RA (2011) Antifibrinolytic therapy with tranexamic acid in pregnancy and postpartum. Expert Opin Pharmacother 12:503–516CrossRefPubMed
Peyvandi F, Garagiula I, Menegatti M (2011) Gynecological and obstetrical manifestations of inherited bleeding disorders in women. J Thromb Haemost 9(Suppl 1):236–241CrossRefPubMed
Pfanner G, Kilgert K (2006) Geburtshilfliche Blutungskomplikationen. Hamostaseologie 26(Suppl 1):56–63
Provan D et al (2010) International consensus report on the investigation and management of primary immune thrombocytopenia. Blood 115:168–186CrossRefPubMed
Ranger A, Manning RA, Lyell H, Laffort A, Miller CM (2012) Pregnancy in type 2B VWD: a case series. Haemophilia 18:406–412CrossRefPubMed
Rath W (2012) Rekombinanter Faktor VIIa – Nutzen und Risiken im off-label use bei postpartalen Blutungen. Frauenarzt 53:334–342
Rath W (2013) Fruchtwasserembolie, Lungenembolie. In: Feige A, Rath W, Schmidt S (Hrsg) Kreißsaal-Kompendium. Thieme, Stuttgart/New York, S 142–149
Rath W, Heilmann L (1999) Vorzeitige Plazentalösung. In: Rath W, Heilmann L (Hrsg) Gerinnungsstörungen in Gynäkologie und Geburtshilfe. Thieme, Stuttgart/New York
Rath W, Kuhn W (1991) Blutungen nach der Geburt des Kindes. Gynakologe 24:160PubMed
Rath W, Lier H (2013) Tranexamsäure und Fibrinogen – unentbehrlich bei schwerer postpartaler Blutung (PPH). Frauenarzt 54:540–547
Rath W, Hofer S, Sinicina I (2014) Fruchtwasserembolie – eine interdisziplinäre Herausforderung. Dtsch ÄRZ BL 111:126–32
Rattray D-D, O’Connell CM, Baskett TF (2012) Acute disseminated intravascular coagulation in obstetrics: a tertiary centre population review (1980 to 2009). J Obstet Gynaecol Can 34:341–347CrossRefPubMed
Rodeghiero F et al (2010) ISTH/SSC bleeding assessment tool: a standardized questionnaire and a proposal for a new bleeding score for inherited bleeding disorders. J Thromb Haemost 8:2063–2065CrossRefPubMed
Roque H, Funai E, Lockwood CJ (2000) von Willebrand disease and pregnancy. J Matern Fetal Med 9:257–266CrossRefPubMed
Rosenkranz A, Hiden M, Leschnik B, Weiss E-C, Schlembach D, Lang U et al (2008) Calibrated automated thrombin generation in normal pregnancy. Thromb Haemost 99:331–337PubMed
Rourke C, Curry N, Khan S (2012) Fibrinogen levels during trauma hemorrhage, response to replacement therapy, and association with patient outcomes. J Thromb Haemost 10:1342–1351CrossRefPubMed
Sadler JE, Budde U, Eikenboom CJ, Favaloro EJ, Hill GH, Holmby L et al (2006) Update on the pathophysiology and classification of von Willebrand disease: a report of the Subcommittee on von Willebrand Factor. J Thromb Haemost 4:2103–2114CrossRefPubMed
Saha P, Stolz D, Atalla R (2009) Haemostatic changes in the puerperium ‚6 weeks post partum‘ (HIP Study) – implications for maternal thromboembolism. BJOG 116:1602–1612CrossRefPubMed
Said JM, Ignajatovic V et al (2010) Altered reference ranges for protein C and protein S during early pregnancy: Implications for the diagnosis of protein C and protein S deficieny during pregnancy. Thromb Haemost 103(5):984–988CrossRefPubMed
Scholz U, Oppermann J, Singemund A, Schobess R (2011) Von-Willebrand-Syndrom Typ 1 und Schwangerschaft. Hamostaseologie 31(Suppl1):11–13
Scully M, ThomasM UM et al (2014) Thrombotic thrombocytopenic purpura and pregnancy: presentation, mangement, and subsequent pregnancy outcomes. Blood 124(2):211–219CrossRefPubMed
Shakur H, Elbourne D, Gülmezoglu M (2010) The WOMAN-Trial (World Maternal Antifibrinolytic Trial): tranexamic acid for the treatment of postpartum haemorrhage: an international randomised, double-blind placebo controlled trial. Trials 11:40–52CrossRefPubMedPubMedCentral
Silver RM, Major H (2010) Maternal coagulation disorders and postpartum hemorrhage. Clin Obstet Gynaecol 53:252–264CrossRef
Simon L, Santi TM, Sacquiri P, Hamza J (1997) Pre-anesthetic assessment of coagulation abnormalities in obstetric patients: usefulness, timing and clinical implications. Br J Anaesth 78:678–683CrossRefPubMed
Sinicina I, Pankratz H, Bisa K, Matevossian E (2010) Forensic aspects of post-mortem histological detection of amniotic fluid embolism. Int J Legal Med 124:55–62CrossRefPubMed
Solomon C, Collis PE, Collins PW (2012) Haemostatic monitoring during postpartum haemorrhage and implications for management. Br J Anaesth. doi:10.1093/bja/aes361PubMedCentral
Srivastava A et al (2013) Guideline for the management of hemophilia. Hemophilia 19:e1–e47CrossRef
Starke R, Machin S, Scully M, Purdy G, Mackie J (2006) The clinical utility of ADAMTS 13 activity, antigen and autoantibody assays in thrombotic thrombocytopenic purpura. Br J Haematol 136:649–655CrossRef
Stella CL, Dacus J, Guzman E et al (2009) The diagnostic dilemma of thrombotic thrombocytopenic purpura/hemolytic uremic syndrom in the obstetric triage and emergency department: lessons from 4 tertiary hospitals. AJOG 200:381e1–381e6CrossRef
Szecsi PB, Jorgensen M et al (2010) Haemostatic reference intervals in pregnancy. Thromb Haemost 103(4):718–727CrossRefPubMed
Taylor FB et al (2001) Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost 86:1327–1330PubMed
Thornton P, Douglas J (2010) Coagulation in pregnancy. Best Pract Clin Res Obstet Gynaecol 24:339–352CrossRef
Tiede A, Barthels M (2013) Disseminierte intravasale Gerinnung. In: Barthels M (Hrsg) Das Gerinnungskompendium. Thieme, Stuttgart/New York, S 192–213
Toh CH, Hoots WK (2007) The scoring system of the scientific and standardisation comittee on disseminated intravascular coagulation of the international society on Thrombosis and Haemostasis: a 5-year overview. J Thromb Haemost 5:604–606CrossRefPubMed
Trigg D, Peitsidis P, Kadir RA (2011) The use of desmopressin (DDAVP) for treatment and prophylaxis of bleeding disorders in pregnancy – a systematic review. Haemophilia 18:25–33CrossRefPubMed
Tsui N, Radir R, Chan K et al (2011) Noninvasive prenatal diagnosis of hemophilia by microfluidics digital analysis of maternal plasma DNA. Blood 117:3684–3691CrossRefPubMed
Uszynski M, Uszynski W (2011) Coagulation and fibrinolysis in amniotic fluid. Semin Thromb Hemost 37:165–174CrossRefPubMed
von Auer C, van Krogh AS, Kremer Hovinga JA, Lämmle B (2015) Current insights into thrombotic microangiopathies. Thromb Res 135(Suppl 1):30–33CrossRef
World Health Organization (WHO) (2009) WHO-Guideline for the management of postpartum haemorrhage and retained placenta. WHO, Geneva. ISBN 978924159851-4
Metadaten
Titel
Gerinnungsstörungen in der Geburtshilfe
verfasst von
Werner Rath
Frauke Bergmann
Copyright-Jahr
2016
Verlag
Springer Berlin Heidelberg
Buch
Die Geburtshilfe

Print ISBN: 978-3-662-45063-5

Electronic ISBN: 978-3-662-45064-2

Copyright-Jahr: 2016

DOI
https://doi.org/10.1007/978-3-662-45064-2_41