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Hematological Complications in Obstetrics, Pregnancy, and Gynecology
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  • 38 b/w illus. 1 colour illus. 106 tables
  • Page extent: 622 pages
  • Size: 247 x 174 mm
  • Weight: 1.38 kg

Library of Congress

  • Dewey number: 618.3
  • Dewey version: 22
  • LC Classification: n/a
  • LC Subject headings:
    • Hematologic Diseases--complications
    • Pregnancy Complications, Hematologic
    • Blood diseases in pregnancy
    • Hematology
    • Obstetrics

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 (ISBN-13: 9780521839532 | ISBN-10: 052183953X)

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Hematological Complications in Obstetrics, Pregnancy, and Gynecology

Cambridge University Press
052183953X - Hematological Complications in Obstetrics, Pregnancy, and Gynecology - Edited by Rodger L. Bick, Eugene Frenkel, William Baker and Ravindra Sarode
Index


Index

ABO blood group 105–7

   ABO-hemolytic disease of the fetus and newborn 107–8

      clinical presentation 107

      diagnosis 108

      fetus management 113–14

      prevalence 107

   incompatibility protective effect against Rh immunization 110

abortion, disseminated intravascular coagulation and 16

abruptio placenta see placental abruption

acidosis, disseminated intravascular coagulation and 18

acquired hemophilia 94–6

   characteristics 94–5

   laboratory findings 95

   treatment 95–6

acquired von Willebrand syndrome (aVWS) 87, 578

      see also von Willebrand disease (VWD)

activated partial thromboplastin time (aPTT) 81–2

   in disseminated intravascular coagulation 26

   lupus anticoagulants and 152, 169–70

activated protein C (APC) 201–2

   resistance 207–8

      acquired 210

      factor V Cambridge mutation 136–7

      factor V HR2 haplotype 137

      factor V Leiden mutation 134–5, 207–8

      management 137

activated prothrombin complex concentrates 96

acute chest syndrome 450–1

acute fatty liver of pregnancy (AFLP) 497

acute heparin reaction 129

ADAMTS13 497–8

adult respiratory distress syndrome (ARDS) 407

adult shock-lung syndrome 24–5

aldosterone synthesis, heparin therapy affect 133

alopecia, heparin therapy and 134

alpha-2-antiplasmin deficiency 385

amniocentesis 475–6, 477

amniotic fluid embolism (AFE) 3–13, 395, 420

   diagnosis 12

   etiology 4–7

      risk factors 6

   incidence 5–6

   management 12–13, 14–15

   mortality 5–6, 7

   pathophysiology 8–9

      hemostasis pathophysiology 10

      pulmonary pathophysiology 9–10

amniotic webs 258

anacrod 563

anaphylaxis, heparin-associated 129

anemia 269, 271, 278, 282, 543

   acute episodes in sickle cell disease 451–2

   megaloblastic 290–1

   microcytic 282

   significance of 269

   see also hemolytic disease of the fetus and newborn; iron deficiency; sickle cell disease

anencephaly 292

annexin-V, antiphospholipid antibody effects 59

antenatal diagnosis see prenatal diagnosis

antepartum hemorrhage 365–6, 367

anti-D IgG therapy 494

anti-Xa drugs 355–6

antibiotics, post partum hemorrhage management 405–6

anticardiolipin antibodies (ACLA) 156–64, 208–9

   assay 156

   autoimmune collagen disease 161–2

   cardiac disease and 158–9

   cutaneous manifestations 159–60

   detection of 169

   lupus anticoagulant correlation 153, 156–7, 171

   miscellaneous disorders 163–4

   neurologic syndromes 160–1

   obstetric syndromes 162–3

   prevalence 168–9

   thrombosis and 149, 156, 157–8, 160–1

      mechanism 157–8

      subclassification 154, 164–6

   see also antiphospholipid syndromes (APLS)

anticoagulant therapy

   disseminated intravascular coagulation management 421–3

   during pregnancy 350–1

   guidelines 351–5

      management of at risk pregnant patients 352

      patients already receiving anticoagulation 353

      patients at risk of pregnancy loss 353–5

      prophylaxis with mechanical heart valves 353

      venous thrombosis treatment during pregnancy 352

   newer anticoagulant drugs 355–7

   see also antithrombotic therapy; heparin treatment; warfarin treatment

antifibrinolytic therapy

   disseminated intravascular coagulation 40

   menorrhagia with von Willebrand disease 577–8

   post partum hemorrhage 403–4

antiphospholipid syndromes (APLS) 148–50, 165, 174, 208–9, 344

   cerebrovascular thrombosis 175–6

   classification 154, 164–6, 209

   clinical presentations 166–8

   coronary artery thrombosis 175

   drugs associated with 168

   laboratory diagnosis 169–72

      detection of antiphospholipid antibody subtypes 171–2

   late pregnancy complications 209

   management 165–6, 209, 351, 353, 354

   prevalence 168–9

   recurrent miscarriage association 58–9, 64, 162–3, 208–9

      mechanisms 59, 61

      monitoring 58

      treatment review 68–9

   types of antiphospholipid antibodies 172

   see also anticardiolipin antibodies (ACLA); lupus anticoagulants (LA)

antiplatelet medications

   bleeding disorders and 82–3

   heparin-induced thrombocytopenia management 565–6

   see also aspirin (ASA) treatment

antithrombin (AT)

   deficiency 140–2, 206–7

      management 141–2

      monitoring 142

   determination, disseminated intravascular coagulation therapy 30–1

   treatment 141–2

      amniotic fluid embolism 13

      disseminated intravascular coagulation 38

      disseminated intravascular coagulation, low-grade DIC 41

antithrombotic therapy

   disseminated intravascular coagulation 37–8

   guidelines 351–5

      management of at risk pregnant patients 352

      patients at risk for pregnancy loss 353–5

      pregnant patients already receiving anticoagulation 353

      prophylaxis with mechanical heart valves 353

      venous thrombosis treatment in pregnancy 352

   newer antithrombotic drugs 355–7

   thrombophilia 122–3, 124–34

      bridging therapy 126–7

      factor V Cambridge mutation 137

      factor V Leiden mutation 135–6

      heparin side effects 128–34

      treatment monitoring 127

   see also heparin treatment; warfarin treatment

Argatroban 565, 566

arterial ligation 414–15

   internal iliac (hypogastric) artery 415

   uterine artery 414

aspirin (ASA) treatment

   platelet inhibition 82

   recurrent miscarriage management 63–4, 162–3, 258, 351

      outcomes 67

      treatment review 68–9

   thrombophilia 123, 137

      factor V Leiden mutation 136

atherosis, acute 254

autoimmune collagen disease, anticardiolipins and 161–2

autosomal dominant inheritance 472–3

autosomal recessive inheritance 471–2

autotransfusion, post partum hemorrhage management 400


B-Lynch suture 416–17

   modified 417

bacterial infection, disseminated intravascular coagulation and 17–18

bed rest, as risk factor for DVT 205–6

Bernard-Soulier syndrome (BSS) 91–2

Bethesda assay 95

bilirubin, in hemolytic disease of the fetus and newborn 105, 114

   exchange transfusion 114

Bivalirudin 565

bleeding disorders 75

   antepartum hemorrhagic diatheses 373–7

      management 376

      screening 372, 373

   evaluation 79–80

      laboratory evaluation 80–2

   genetic counseling 96

   post partum hemorrhage prevention 373–7

      see also post partum hemorrhage

   prenatal testing 96

   primary hemostatic defect 82–92

      antiplatelet medications and 82–3

   recurrent miscarriage associations 55–6, 57, 63

   secondary hemostatic dysfunction 92–6

   uremic bleeding 91

   see also hemorrhage; specific disorders

blood coagulation protein/platelet defects, in recurrent miscarriage 55–8

blood component therapy 528, 533

   administration 540–1

   blood collection 528–9

   cryoprecipitate (CRYO) 538–40, 546

      indications 539–40

      preparation and storage 538–9

   disseminated intravascular coagulation 39–40

   fresh frozen plasma (FFP) 537–8, 546

      indications 537–8

      preparation and storage 537

   modifications to whole blood and components 540

      irradiation 540

      leukocyte reduction 540

      washing 540

   new pharmacological agents 541–3

      erythropoietin (EPO) 541–2

      recombinant factor VIIa (Novoseven) 542

      red blood cell substitutes 541

   packed red blood cells (PRBCs) 534–5

      indications 534–5

      preparation and storage 534

   platelets 535, 546

      considerations 536–7

      indications 536

      intrauterine platelet transfusion (IUPT) 514–15

      random donor platelets (RDPs) 535

      single donor platelets (SDPs) 535–7

      transfusion 401–2, 495, 499

   post partum hemorrhage 398–402

   whole blood 531–4

      indications 534

      preparation and storage 531

      use with massive hemorrhage 545–6

   see also blood transfusion

blood donation 528–9

blood pressure, post partum hemorrhage monitoring 406

blood transfusion 540–1

   autotransfusion, post partum hemorrhage management 400

   disseminated intravascular coagulation (DIC) 547

   exchange transfusion, hemolytic disease of the fetus and newborn 114

   management 544

      guidelines 544

   massive transfusion 538, 544–6

      complications 546

      CRYO 546

      definition 544

      fresh frozen plasma 546

      laboratory investigation 544–5

      platelets 546

      treatment 545

      uncrossmatched, emergency release red blood cells 545

      whole blood 545–6

   pretransfusion compatibility testing 530–1

   risks of transfusion therapy 529–30

      infectious risks 529–30

      non-infectious risks 530

   sickle cell disease management during pregnancy 449–50, 547–8

      at delivery 450

      red blood cell exchange (RBCx) 547–8

   see also blood component therapy; intra-uterine transfusion

bone density, heparin therapy effects 129–32, 350

breast cancer

   folate intake relationship 295

   venous thrombosis risks 310

      during chemotherapy 320–7

      prophylaxis 326–7

   see also malignancy


cesarean section, as risk factor for DVT 202–3

cancer see malignancy; specific types of cancer

cardiac disease, anticardiolipins and 158–9

   myocardial infarction 158–9

   valvular disease 159

central venous catheters, venous thrombosis risks 327–31

   prophylaxis 328–31, 333

central venous pressure monitoring 406–7

cerebrovascular events

   antiphospholipid antibodies and 160–1, 175–6

   with sickle cell disease 451

chemotherapy, venous thrombosis risks 320–7

   prophylaxis 326–7, 332–3

chorangiomas 258–9

chorionic villus sampling (CVS) 476, 477

Christmas disease 382–3

chronic venous insufficiency (CVI) 212

clopidogrel

   antiphospholipid syndrome management 165–6

   platelet inhibition 83

coagulation 3–16, 77–9, 373

   defects

      menorrhagia and 571–2, 573, 574–81

      recurrent miscarriage syndrome and 55–8

      surgical considerations 582–3

      see also specific defects

   inhibitors of 94

      acquired hemophilia 94–6

   see also disseminated intravascular coagulation (DIC)

coagulation factor

   assays, disseminated intravascular coagulation 26–7

   deficiencies 93–4

cobalamin see vitamin B12

colon cancer

   folate status relationship 295

   see also malignancy

complement activation, disseminated intravascular coagulation 21

compression ultrasound (CUS) 213

contraception

   oral, menorrhagia treatment with von Willebrand disease 577

   sickle cell disease and 453

coronary artery thrombosis 175

coumadin 563

counseling see genetic counseling

Creutzfeldt-Jakob disease (CJD) 529–30

cryoprecipitate (CRYO) 538–40

   dysfibrinogenemia management 377

   in massive transfusion 546

   indications 539–40

   post partum hemorrhage management 402

   preparation and storage 538–9

   use in surgery 583

   von Willebrand disease management 89, 388


D-Dimer assay

   disseminated intravascular coagulation 27–8

   DVT diagnosis 213–14

Dallas Thrombosis Hemostasis Clinical Center, recurrent miscarriage experience 61–9

   flow protocol 61

   management 63–6

   outcomes 67

   patient characteristics 62–3

   treatment review 68–9

dalteparin see heparin treatment

danaparoid (Organon) 564

danazol, menorrhagia treatment 581

DDAVP (desmopressin)

   factor VIII: C defect management 380–1

   platelet aggregation disorder management 579

      during surgery 583

   von Willebrand disease management 89–90, 388

      preoperative treatment 582–3

      with menorrhagia 576–7

deep vein thrombosis (DVT)

   diagnosis in pregnancy 213–14

   incidence in pregnancy 200

   long-term outcome 212

   management in pregnancy 214–16

      at time of delivery 215–16

   mortality 201

   pathogenesis in pregnancy 201–2

   prophylaxis in pregnancy 210–13

      heparin dosage 211, 212, 215

      with prosthetic heart valves 212

   risk factors 202–6, 210–11

      age at delivery 205

      bed rest and obesity 205–6

      cesarean section 202–3

      previous history 204, 210

   risk of in pregnancy 122, 211

   thrombophilia and 206–10

      antiphospholipid syndrome 208–9

      inherited thrombophilia 134–6, 206–8

   see also thrombophilia in pregnancy; thrombosis; venous thromboembolism (VTE)

Dego’s disease 159–60

delivery

   deep vein thrombosis management 215–16

   post partum hemorrhage prevention 389–92

   with sickle cell disease 450

desmopressin see DDAVP

dilute Russell’s viper venom time (dRVVT) 152–3, 170

   anticoagulant therapy effects 170–1

direct antiglobulin test (DAT) 108–10

disseminated intravascular coagulation (DIC) 1–3, 418–23, 546–7

   associated disorders 2, 3, 4, 5, 421

   clinical diagnosis 22–3, 33, 422

      low-grade DIC 23

   definition 2

   etiology 3–18, 419–20, 546–7

      disorders not specific to pregnancy or gynecology 5, 17–18

      disorders specific to gynecology 16–17

      disorders specific to pregnancy and obstetrics 3–16

   historical perspectives 3

   laboratory diagnosis 22, 25–35

      global coagulation tests 25–9

      molecular markers 29–35

   management 35–41, 421–3, 547

      anticoagulants 421–3

      fresh frozen plasma 538

      fulminant DIC 35–40

      low-grade DIC 40–1

      removal of triggering pathophysiology 36–7

      transfusion therapy 547

      with post partum hemorrhage 402, 403–4

   morphological findings 23–5

   pathophysiological events 19–22

   prevention 420–1

dysfibrinogenemia 139, 377

   treatment 377, 539


eclampsia 13–15

   disseminated intravascular coagulation and 13–15

   with sickle cell disease 453

   see also preeclampsia

embolization, post partum hemorrhage management 408–10

enaxta 355

endometrial ablation, menorrhagia treatment 582–3

endotoxin, disseminated intravascular coagulation and 17–18

enoxaparin (Lovenox), safety issues in pregnancy 65–7, 125, 127, 556–7

   adverse effects 67

      non-teratogenic effects 66–7

      teratogenic effects 66

   see also heparin treatment

enzyme-linked immunosorbent assay (ELISA) 509

eosinophilia, heparin therapy and 133

epsilon aminocaproic acid (AECA)

   disseminated intravascular coagulation therapy 40

   menorrhagia treatment with von Willebrand disease 578

   post partum hemorrhage management 403–4

ergotamine 391

erythroblastosis fetalis 105

erythropoietin (EPO) 541–2


Factor Eight Inhibitor Bypass Activity (FEIBA) 96

factor II defects 377–8

   management 378–9

factor V defects 378–9

   Cambridge mutation 136–7

   Hong Kong mutations 137

   HR2 haplotype 137

   Leiden mutation 134–6, 207–8

      factor V HR2 haplotype effect 137

      management 135–6

      recurrent miscarriage association 60

   menorrhagia and 580

factor VII defects 379–80

   management 379–80

   menorrhagia and 580

factor VIIa

   post partum hemorrhage management 402

   recombinant (Novoseven) 542

factor VIII

   deficiency (hemophilia A) 380–2

      inheritance patterns 478–80

      management 380–2

      von Willebrand disease comparison 388

   elevation 210

   inhibition see acquired hemophilia

   replacement therapy during surgery 583

factor IX

   deficiency (hemophilia B) 382–3

      inheritance patterns 478–80

      management 382–3

   elevation 210

factor X

   activation, in disseminated intravascular coagulation 10, 17

   deficiency 383–4

      management 383–4

factor XI

   deficiency 93, 384

      management 384

      menorrhagia and 580

   elevation 210

factor XII deficiency (Hageman trait) 139

factor XIII deficiency 385–6, 539

   management 386, 539

ferritin measurement 279–80

fetal hydrops see hydrops fetalis

fetal scalp sampling 514

fetal thrombotic vasculopathy 260

fetal wastage syndrome see recurrent miscarriage syndrome

fibrin

   in disseminated intravascular coagulation 19–20, 21

      assays 27

   placental, obstructive lesions and 254–5

      intimal fibrin cushions 260

      maternal floor infarction 255

fibrinogen defects 139, 377, 539

   treatment 377, 539

fibrin(ogen) degradation products (FDPs), in disseminated intravascular coagulation 19–20

   assays 27–9

fibrinolytic system defects

   disseminated intravascular coagulation 31–2, 40

      antifibrinolytic therapy 40

      assays 31–2

   thrombosis and 145–6

fibrinopeptide A (FPA) assay 29–30, 31

fibromuscular sclerosis 260

Fletcher factor deficiency 384

FM-test, disseminated intravascular coagulation 27

folate 284–5

   cancer and 294–5

      breast cancer 295

      colon cancer 295

   deficiency

      diagnosis 287–9

      hematological sequelae 290–1

      neural tube defects 292–3

      treatment 295–6

   food fortification 289–90, 292–3

   homocysteine interrelationship 285–6

   in sickle cell disease 449

   preeclampsia and 294

   requirements during pregnancy 289–90

Foley catheter 412

fractures, heparin therapy association 129–32, 350

fresh frozen plasma (FFP) 537–8, 546

   indications 537–8

   post partum hemorrhage management 400–1

   preparation and storage 537


gelfoam 409

genetic counseling 469, 470–4

   β thalassemia 460

   bleeding disorders 96

      hemophilia 478–80

      von Willebrand disease 484–5

   components of 470–4

      choosing course of action 473–4

      making best possible adjustment 474

      understanding alternatives for dealing with risk 473

      understanding heredity and risk of recurrence 471–3

      understanding medical facts 471

   Hb H disease 457–8

   hemoglobinopathies 480–4

      sickle cell disease 453

   hydrops fetalis 457–8

   thrombophilia 477–8

   see also inheritance patterns

genetic counselors 470

Glanzmann’s thrombasthenia (GT) 92, 579

gonadotropin releasing hormone (GnRH), menorrhagia treatment 581


Hageman trait 139

Helicobacter pylori infection, thrombocytopenia and 495

HELLP syndrome 14–16, 420, 496

   disseminated intravascular coagulation and 15–16

   management 496

hemangiomas, umbilical 258–9

hemoglobin 442

   function 442

   Hb Bart’s hydrops fetalis 456–9, 483–4

      fetal and maternal complications 457

      gene deletions 457

      genetic counseling 457–8

   Hb H disease 456, 458, 483–4

      genetic counseling 457–8

      pregnancy 456

      prenatal diagnosis 458–9

   levels 278–9

      monitoring following post partum hemorrhage 406

   mutations 442–3, 454–5

      inheritance patterns 480–4

   see also anemia; iron deficiency; sickle cell disease; thalassemias

hemolytic disease of the fetus and newborn (HDFN)

   alloimmunized female management during pregnancy 112

   erythrocyte antigens implicated 105–11, 486–7

      ABO blood group system 105–8

      anti-Kell 110, 486–7

      diagnosis 110

      Rh (D) 108–10

      see also ABO blood group; Rh isoimmunization

   fetus management 112–14

      amniocentesis and Liley curves 112–13

      intra-uterine transfusion (IUT) 113–14

   neonate management 114

   pathophysiology 103–5

      effects on fetus 105

      events leading to disease 103–5

      hydrops fetalis 105

   prevention in Rh(D) negative, unsensitized female 111–12

   protective effect of ABO-incompatibility 110

hemolytic uremic syndrome (HUS) 499–500

hemophilia, acquired see acquired hemophilia

hemophilia A (factor VIII deficiency) 380–2

   inheritance patterns 478–80

   management 380–2

   von Willebrand disease comparison 388

hemophilia B (factor IX deficiency) 382–3

   inheritance patterns 478–80

   management 382–3

hemophilia carriers, menorrhagia and 580

hemorrhage 543–4

   antepartum hemorrhage 365–6, 367

   antepartum hemorrhagic diatheses 373–7

      management 376

      screening 372, 373

   gastrointestinal, iron deficiency and 274–5, 282

   heparin therapy side effect 128–9

   in disseminated intravascular coagulation 2, 20, 21, 22

      management 39–40

      see also disseminated intravascular coagulation

   intracranial (ICH), with neonatal alloimmune thrombocytopenia 513

   physiologic parturition hemorrhage 362

   placental 250

      disturbances of fetal vascular integrity 260–2

      disturbances of maternal vascular integrity 255–7

      iatrogenic 261–2

      see also placenta

   see also bleeding disorders; post partum hemorrhage (PPH)

hemorrhagic endovasculitis 260

hemorrhagic shock 393–6

   clinical manifestations 395

   consequences 365

   resuscitation 396–8

   severity indices 394

   see also post partum hemorrhage

hemostatic sutures 415–18

   B-Lynch suture 416–17

      modified 417

   multiple square suturing 417–18

hemostatic system 75–7

   antepartum hemorrhagic diatheses 373–7

      management 376

      screening 372, 373

   clotting system during pregnancy 79

   hemostasis mechanism with menstruation 571

   hemostatic changes during pregnancy 202, 342–3, 371

   primary hemostasis 75–7

      laboratory evaluation 80–1

      primary hemostatic defect 82–92

   secondary hemostasis 76–7

      laboratory evaluation 81–2

heparin cofactor II (HC-II) deficiency 142

heparin-induced thrombocytopenia (HIT) 354, 556, 557–66

   clinical testing 562–3

      functional tests 562

      quantitative tests 562–3

   differential diagnosis 561–2

   frequency 559

   HIT-associated thrombosis 560–1

   management 561, 563–6

      alternative anticoagulants 563

      antiplatelet agents 565–6

      Argatroban 565, 566

      coumadin 563

      danaparoid (Organon) 564

      direct thrombin inhibitors 564, 566

      hirudin 564–5, 566

   pathophysiology 559–60

   risk factors 560

   type I 557–8

   type II 558–9

heparin treatment 346, 350–1, 556–7

   amniotic fluid embolism 13

   disseminated intravascular coagulation 37–8

      low-grade DIC 41

   DVT management 214–16

      at time of delivery 215–16

   DVT prophylaxis 210, 211

      dosage 211, 212, 215

      with prosthetic heart valves 212

   low molecular weight heparin (LMWH) properties 344–50

      use in pregnancy 350–1

   prophylaxis in cancer patients

      during chemotherapy 326, 327

      during surgery 315–19, 331–2

      with central venous catheters 331, 333

   recurrent miscarriage management 63–6, 162–3, 351

      outcomes 67

      treatment review 68–9

   safety issues in pregnancy 65–7, 125, 127, 212–13, 556–7

   side effects 128–34, 213, 556

      acute heparin reaction 129

      alopecia 134

      altered liver function 133

      bleeding 128–9

      eosinophilia 133

      metabolic abnormalities 133

      osteoporosis 129–32, 350

      skin reactions 132–3

      see also heparin-induced thrombocytopenia (HIT)

   thrombophilia 123, 124–34, 137

      antiphospholipid syndromes 165–6, 209, 351, 353, 354

      bridging therapy 126–7

      factor V Leiden mutation 135–6

      lupus anticoagulant thrombosis syndrome 155–6

      protein C deficiency 142–4

      protein S deficiency 144–5

      treatment monitoring 127

   venous thrombosis management guidelines in pregnancy 352

      at risk patients 352

      patients already receiving anticoagulation 353

      patients at risk for pregnancy loss 353–5

      patients with mechanical heart valves 353

   see also antithrombotic therapy

hepatosplenomegaly, hemolytic disease of the fetus and newborn 105

hirudin 564–5, 566

homocysteine 284–6

   folate and vitamin B12 interrelationship 285–6

      use in folate and vitamin B12 deficiency diagnosis 288

   homocyst(e)inemia 139–40

      management 140

   hyperhomocysteinemia 286–7

      intrauterine growth retardation and 294

      miscarriage and 293

      preeclampsia and 294

      treatment 296–7

homocystinuria 286

hormone releasing intrauterine device, menorrhagia treatment 581

human leukocyte antigens (HLA) 516–17

   anti-HLA antibodies 517

human platelet antigen (HPA) polymorphisms 507–8

   HPA-1 system 508

   HPA-3 system 508

   HPA-5 system 508

Humate-P 88–9, 90–1, 388

hyaline microthrombi, disseminated intravascular coagulation 24–5

hydrops fetalis 105, 112

   genetic counseling 457–8

   Hb Bart’s hydrops fetalis 456–9, 483–4

      fetal and maternal complications 457

      gene deletions 457

hydroxyurea, sickle cell disease management 448

hyperbilirubinemia, in hemolytic disease of the fetus and newborn 105, 114

   exchange transfusion 114

hyperhomocysteinemia 286–7

   intrauterine growth retardation and 294

   miscarriage and 293

   preeclampsia and 294

   treatment 296–7

   see also homocysteine

hyperkalemia, heparin therapy and 133

hypertrophic decidual vasculopathy 254

hypoaldosteronism, heparin therapy and 133

hypogastric artery ligation 415

hypovolemic shock see hemorrhagic shock

hysterectomy

   menorrhagia management 581–2

   post partum hemorrhage management 418


immune thrombocytopenic purpura (ITP) 492–5, 517–18

   clinical presentation 492, 517

   diagnosis 492

      differential diagnosis 518

      laboratory values 518

   fetal assessment 493

   history 518

   management 492–5, 518

   neonatal 519

      assessment 493

      degree of thrombocytopenia 519

      incidence 519

      management 493, 519

   pathophysiology 517

immunosuppressive therapy

   acquired hemophilia 96

   lupus anticoagulant thrombosis syndrome 154

impedence plethysmography (IPG)

implantation 253

   superficial implantation 253

      placental lesions 254

infarction, placental 255

   maternal floor infarction 255

inheritance patterns 470

   autosomal dominant inheritance 472–3

   autosomal recessive inheritance 471–2

   genetic counseling 471–3

   hemoglobinopathies 480–4

      sickle cell disease 481

   hemophilia 478–80, 489

   Rh blood group system 486

   thrombophilia 477–8

   von Willebrand disease 484–5

   X-linked inheritance 473

interhemal membrane see placenta

internal iliac artery ligation 415

intrauterine growth retardation (IUGR)

   homocysteine and 294

   maternal underperfusion and 254

intrauterine transfusion (IUT), fetal hemolytic disease management 113–14

   indications 113

   red blood cells 113–14

intracranial hemorrhage (ICH), with neonatal alloimmune thrombocytopenia 513

intravenous gamma globulin (IVIg) therapy, thrombocytopenia 494

   fetal thrombocytopenia treatment 512

iron deficiency 269, 270–84

   causes 271, 274–5

   clinical manifestations 276–7

   development of 272

   diagnosis 277–80

      history and physical examination 277–8

      laboratory studies 278–80

   diagnostic evaluation 281–2

   pregnancy and 271, 273

   prevalence 270–1

   screening 281

   supplementation in sickle cell disease 449

   treatment 282–4

   see also anemia

iron homeostasis 271–5, 274

   absorption from diet 272, 275–6

   body iron distribution 272

   during pregnancy 275–6

   environmental influences 274–5

   iron loss 273–4

      during pregnancy 273

Ivalon® particles 409


Jehovah’s Witnesses 542–3


kaolin clotting time (KCT) 153, 170

Kell antigen 110, 486–7

kinin system activation, disseminated intravascular coagulation 21

kininogen deficiency 385


labor management, post partum hemorrhage prevention 389–92

   see also delivery

laparotomy, post partum hemorrhage treatment 414–18

   arterial ligation 414–15

      internal iliac (hypogastric) artery 415

      uterine artery 414

   hemostatic sutures 415–18

Lepirudin 564–5

LeVeen shunts 17

Liley curves 112–13

liver disease 537

liver function, heparin therapy effects 133

livido reticularis 159, 161

Lovenox (enoxaparin), safety issues in pregnancy 65–7, 125, 127, 556–7

   adverse reactions 67

      non-teratogenic effects 66–7

      teratogenic effects 66

   see also heparin treatment

low molecular weight heparins (LMWHs) 344–50

   clinical trials 349

   dosages 347–8

   heterogeneity 347–9

   indications 348, 349

   mechanism of action 347

   preparation of 345–6

   use in pregnancy 350–1

   see also heparin treatment

lupus anticoagulants (LA) 150–6, 208–9

   anticardiolipin antibody correlation 153, 156–7, 171

   assays 152–3, 169–71

   thrombosis and 149, 150–1

      management 154–6

      mechanisms 153

      subclassification 154

   see also antiphospholipid syndromes (APLS)


magnetic resonance venography

malignancy 310–11

   disseminated intravascular coagulation and 16–17

   venous thrombosis prophylaxis 310–11

      during chemotherapy 326–7, 332–3

      during radiotherapy 320

      during surgery 315–19, 331–2

      recommendations 331–3

      with central venous catheters 328–31, 333

   venous thrombosis risks 310, 311–14

      age and 312–13, 314–19

      during cancer surgery 312–13, 314–19

      during chemotherapy 320–7

      during radiotherapy 319–20

      influencing factors 311–14

      with central venous catheters 327–31

   see also specific types of cancer

menorrhagia 570

   alternative treatments 581

   coagulation defects and 571–2, 574–81

      acquired von Willebrand syndrome 578

      factor V deficiency 580

      factor VII deficiency 580

      factor XI deficiency 580

      hemophilia carriers 580

      platelet disorders 578–9

      thrombocytopenia 579–80

      von Willebrand disease 571–2, 574–8

      warfarin 581

   determination of 571

   surgical treatment 581–2

      considerations with coagulation defects 582–3

   under-appreciation of coagulation defects 571–2

   work up in coagulation defect patient 573–4

menstruation disorders 570

   hemostasis mechanism 571

   see also menorrhagia

methionine synthesis pathway 285–6

methylenetetrahydrofolate reductase (MTHFR) 285–6

   C677T mutations 140, 286–7, 296–7

      recurrent miscarriage association 60, 293, 353

methylmalonic acid (MMA) 288

miscarriage

   homocysteine relationship 293

   see also recurrent miscarriage syndrome (RMS)

misoprostol 391, 403

modified B-Lynch suture 417

molecular marker profiling, disseminated intravascular coagulation 34

monoclonal antibody specific immobilization of platelet antigens assay (MAIPA) 510

Montpellier Antiphospholipid (MAP) study 168

multiple organ dysfunction syndrome (MODS)

   clinical manifestations 366

   with post partum hemorrhage 364, 425

myocardial infarction, anticardiolipins and 158–9


neonatal alloimmune thrombocytopenia (NAITP) 507–17

   caused by human leukocyte antigens (HLA) 516–17

      anti-HLA antibodies 517

      diagnosis 517

   caused by human platelet antigens (HPA) 507–12

      clinical presentation 508–9

      diagnosis 509–11

      HPA polymorphisms 507–8

      incidence 507

      maternal history 509

      pregnancy management in alloimmunized mother 511–12

      prenatal screening 511

      prenatal therapeutic strategies 512

   clinical presentation 512–13

   fetal management 513–15

      fetal platelet count determination 513–14

      intrauterine platelet infusion (IUPT) 514–15

   intracranial hemorrhage (ICH) 513

   neonate management 515–16

      transfusion therapy 515–16

NESP (novel erythropoiesis-stimulating factor) 541

neural tube defects (NTDs) 292–3

   folate deficiency relationship 292–3

   vitamin B12 status and 293

non-steroidal anti-inflammatory drugs (NSAIDs), platelet inhibition 82–3

Novoseven (recombinant factor VIIa) 542


obesity, as risk factor for DVT 205–6

O’Leary stitch 414

oral contraceptives, menorrhagia treatment with von Willebrand disease 577

Organon 564

osteoporosis, heparin-associated 129–32, 350

ovarian cancer

   venous thrombosis risks 310, 316

      during chemotherapy 324–5

   see also malignancy

ovarian hyperstimulation syndrome

oxytocin

   role in uterine contractions 390

   use as uterotonic agent 390–1, 403


packed red blood cells (PRBCs) 534–5

   indications 534–5

   post partum hemorrhage management 398–400

   preparation and storage 534

parturition

   hemorrhage 362

   maternal physiology 371–2

parvovirus B19 infection 449–50, 452

Passovoy defect 385

pentasaccharide 355

percutaneous umbilical blood sampling (PUBS) 476

   thrombocytopenia assessment 493, 514

pictorial blood measurement chart (PBMC) 571

placenta 250–2

   fetal perfusion 251–2

      developmental lesions 258–9

      disturbances of fetal vascular integrity 258, 260–2

      obstructive lesions 258, 259–60

   maternal perfusion 250–1

      developmental lesions 253–4

      disturbances of maternal vascular integrity 253, 255–7

      obstructive lesions 253, 254–5

   sickle cell disease effects 445

   thrombophilia and 259, 262–3

placental abruption 255–7, 389

   chronic abruption 256

   disseminated intravascular coagulation and 13

   marginal abruption 256

plasma exchange (PE) therapy, thrombotic thrombocytopenic purpura 499

plasmin, in disseminated intravascular coagulation 19, 20–1

   assays 31–2

plasmin-alpha-2-plasmin inhibitor (PAP) complex assay 31–2

plasminogen activator inhibitor type I (PAI-1) elevation 146

plasminogen deficiency 145–6

platelet antigen genotyping 510–11

   paternal 511–12

platelet beta-thromboglobulin assay 32

platelet count 80

   disseminated intravascular coagulation 32

   fetal 506

   primary platelet disorders 91–2

platelet defects 91–2, 389

   antiplatelet medication effects 82–3

   in recurrent miscarriage 55–8

   menorrhagia and 578–9

      diagnosis 579

      prevalence 578–9

      treatment 579

   surgical considerations 583

   see also thrombocytopenia

platelet factor 4 assay 32

platelet function tests

   in disseminated intravascular coagulation 32

   platelet aggregation studies 81, 562

   Platelet Function Analyzer-100 (PFA-100) 80–1

platelet suspension immunofluorescence test (PSIFT) 509–10

platelet transfusion 546

   intrauterine transfusion (IUPT) 514–15

   neonatal alloimmune thrombocytopenia management 515–16

      use of maternal platelets 516

   post partum hemorrhage management 401–2

   random donor platelets (RDPs) 535

   single donor platelets (SDPs) 535–7

   thrombocytopenia 495

   thrombotic thrombocytopenic purpura and 499

post partum hemorrhage (PPH) 361–2

   antepartum hemorrhage as predictor 365–6

   blood component therapy 398–402

      autotransfusion 400

      cryoprecipitate 402

      fresh frozen plasma 400–1

      packed red blood cells 398–400

      platelets 401–2

   causes 369, 370

      etiology determination 408

   definitions 363, 364

   diagnosis 392–3

   disseminated intravascular coagulation 418–23

      management 421–3

      prevention 420–1

   factor VII therapy 402

   incidence 362–3

   interventional radiology 408–10

   massive (severe) PPH 363–5

   monitoring 406–8

   morbidity and mortality 362–3

   pharmacologic therapy 403–6

      antibiotics 405–6

      antifibrinolytic agents 403–4

      uterotonics 391, 403

      vasopressors 404–5, 407

   prenatal screening evaluation 372, 373

   prevention 372–92

      alpha-2-antiplasmin deficiency 385

      antepartum hemorrhagic diatheses 373–7

      antepartum preparation 372, 376

      factor II defects 377–8

      factor V defects 378–9

      factor VII defects 379–80

      factor VIII: C defects 380–2

      factor IX defects 382–3

      factor X deficiency 383–4

      factor XI deficiency 384

      factor XIII deficiency 385–6

      fibrinogen defects 377

      kininogen deficiency 385

      labor management 389–92

      Passovoy defect 385

      platelet defects 389

      prekallikrein deficiency 384

      von Willebrand disease 386–8

   resuscitation 396–8

   risk factors 367, 369

   surgical management 411–18

      arterial ligation 414–15

      hemostatic sutures 415–18

      hysterectomy 418

      tamponade 411–14

postthrombotic syndrome 212

preeclampsia 13–15, 495–6

   acute atherosis and 254

   homocysteine and 294

   thrombocytopenia association 495–6

   with sickle cell disease 452

pregnancy termination, with sickle cell disease 450

preimplantation genetic diagnosis (PGD) 476–7

prekallikrein deficiency 384

prenatal diagnosis 469, 474–7

   amniocentesis 475–6, 477

   β thalassemia 460–1, 481

   bleeding disorders 96

      von Willebrand disease 485

   chorionic villus sampling (CVS) 476, 477

   Hb H disease 458–9

   neonatal alloimmune thrombocytopenia 511

   percutaneous umbilical blood sampling (PUBS) 476

   preimplantation genetic diagnosis (PGD) 476–7

   prerequisites 474–5

   Rh-D status 486

   sickle cell disease 449, 453, 481

   thrombocytopenia 493

proconvertin deficiency 379–80

progestin releasing intrauterine device, menorrhagia treatment 581

prostaglandins

   role in uterine contractions 390

   uterotonic use 403

      side effects 403

prosthetic heart valves

   enoxaparin (Lovenox) safety issues in pregnancy 65–7, 127, 557

   thrombosis prophylaxis during pregnancy 212, 353

protein C 142

   deficiency 142–4, 206–7

      management 142–4

   see also activated protein C (APC)

protein S 144

   deficiency 144–5, 206–7

      management 144–5

prothrombin deficiency 377–8

   treatment 378

prothrombin fragment 1.2 (PF 1 + 2) assay 29–30, 31

prothrombin G20210A mutation 137–9, 207–8

   management 138–9

   recurrent miscarriage association 60

   thrombosis risk 137–8

prothrombin time (PT) 81

   in disseminated intravascular coagulation 25–6

pulmonary angiography

pulmonary artery catheter 407

pulmonary embolism (PE)

   diagnosis 213–14

   incidence in pregnancy 200

   mortality 201

   previous history as risk factor 204

   risk in pregnancy 122

   see also thrombophilia in pregnancy; thrombosis; venous thromboembolism (VTE)

pulmonary hyaline membranes 24–5

pulse, post partum hemorrhage monitoring 406


rabbit brain neutralization procedure 170

radiotherapy, venous thrombosis risks 319–20

recombinant factor VIIa (Novoseven) 542

recurrent miscarriage syndrome (RMS) 55

   blood coagulation protein/platelet defects and 55–8

      hemorrhagic defects 55–6, 57, 63

      procoagulant defects 58–61

      thrombotic defects 56–7

   causes 55, 56, 176

      antiphospholipid antibody association 58–9, 64, 162–3, 208–9

   Dallas Thrombosis Hemostasis Clinical Center experience 61–9

      flow protocol 61

      management 63–6

      outcomes 67

      patient characteristics 62–3

      treatment review 68–9

   management 63–6, 162–3, 351

      guidelines 353–5

red blood cell substitutes 541

Refludan® 564–5

reptilase time, disseminated intravascular coagulation 26

resuscitation, post partum hemorrhage 396–8

retained fetus syndrome, disseminated intravascular coagulation 13

Rh immunoglobulin (RhIG) administration 111–12, 486

Rh isoimmunization 108–10, 485–7

   hemolytic disease of the fetus and newborn 107, 108–9

      alloimmunized female management during pregnancy 112

      clinical presentation 109–10

      diagnosis 110

      fetus management 112–13

      partial D variant 109

      prevention in Rh(D) negative, unsensitized female 111–12

      protection by ABO-incompatibility 110

   inheritance patterns 486

   prenatal testing 486

rituximab 499

ruptured vasa previa 258

Rusch catheter 413


schistocytes 24

screening

   antepartum hemorrhagic diatheses 372, 373

   β thalassemia 460, 461, 462, 463

   iron deficiency 281

Sengstaken–Blakemore catheter 412–13

septicemia, disseminated intravascular coagulation and 17–18

   management 37

serotonin release assay (SRA) 562

sickle cell disease 255, 444–54, 547–8

   complications 450–3

      acute anemic episodes 451–2

      acute chest syndrome 450–1

      CNS events 451

      eclampsia 453

      painful episode 451

      preeclampsia 452

      pregnancy-related complications 447

      small for gestational age 452

   contraception and 453

   genetic counseling 453

   inheritance patterns 481

   placental circulation 445

   pregnancy in 445–7

   pregnancy management 445–450

      antenatal care 447–8

      blood transfusion 449–50, 547–8

      delivery 450

      laboratory testing 448–9

      puerperium 450

      supplements 449

      termination 450

   prenatal diagnosis 449, 453, 481

   sickle erythrocyte characteristics 444–5

   sickle hemoglobin 443

sickle cell trait 453–4

skin conditions

   anticardiolipins and 159

   heparin-related 132–3

Sneddon’s syndrome 159, 160

solid phase red cell assay (SPRCA) 510

spina bifida 292

splenectomy 494–5

Sticky Platelet Syndrome (SPS) 147–8

   management 148

stroke

   antiphospholipid antibodies and 160–1, 175–6

   with sickle cell disease 451

syncytial knots 254

syntometrine 391

systemic inflammatory response syndrome (SIRS) 418–19

systemic lupus erythematosus 150

   cardiac valvular disease and 159

   see also lupus anticoagulants (LA)


tamoxifen therapy, venous thrombosis risk and 321, 326

tamponade, post partum hemorrhage management 411–14

   Foley catheter 412

   large volume balloon 413–14

   Rusch catheter 413

   Sengstaken–Blakemore catheter 412–13

   uterine packing 412

   vaginal tamponade 412

thalassemias 443

   α thalassemia 455–6, 481–4

   β thalassemia 459–61, 481

      genetic counseling 460

      heterozygotes 460

      prenatal diagnosis 460–1, 481

      screening 460, 461, 462, 463

   Hb Bart’s hydrops fetalis 456–9, 483–4

      fetal and maternal complications 457

      gene deletions 457

      genetic counseling 457–8

thrombin

   consequences of systemic activity 19–22

   inhibitors, use in heparin-induced thrombocytopenia 564

      Argatroban 565, 566

      Bivalirudin 565

      guidelines 566

      hirudin 564–5, 566

   see also antithrombin (AT)

thrombin time (TT) 82

   in disseminated intravascular coagulation 26

thrombocytopenia 83, 389, 490, 498

   acute fatty liver of pregnancy (AFLP) 497

   causes during pregnancy 491

   differential diagnosis 561

   fetal

      assessment 493, 513–14

      management 513–15

      presentation 512–13

   gestational (physiological) thrombocytopenia 490–1

   hemolytic uremic syndrome (HUS) 499–500

   immune thrombocytopenic purpura (ITP) 492–5

   menorrhagia and 579–80

   neonatal 506

      see also immune thrombocytopenic purpura (ITP); neonatal alloimmune thrombocytopenia (NAITP)

   pathological thrombocytopenia 491–5

   preeclampsia/eclampsia association 495–6

   thrombotic thrombocytopenic purpura (TTP) 497–9

   see also HELLP syndrome; heparin-induced thrombocytopenia (HIT)

thrombogenesis 342

thrombophilia in pregnancy 122–4, 134, 206–10, 344, 477–8

   antiphospholipid syndromes 148–50, 208–9, 344

      anticardiolipins 156–64, 208–9

      classification 154, 164–6

      lupus anticoagulants (LA) 150–6, 208–9

   antithrombin (AT) deficiency 140–2, 206–7

   antithrombotic therapy 122–3, 124–34

      bridging therapy 126–7

      heparin side effects 128–34

      treatment monitoring 127

   see also specific conditions

   dysfibrinogenemia 139, 377

   factor V Cambridge mutation 136–7

   factor V Hong Kong mutations 137

   factor V HR2 haplotype 137

   factor V Leiden mutation 134–6, 207–8

   factor XII deficiency (Hageman trait) 139

   fibrinolytic defects 145–6

   genetic testing 478

   heparin cofactor II (HC-II) deficiency 142

   homocyst(e)inemia 139–40

   inheritance 477–8

   management guidelines 352

   placental pathology 262–3

   protein C deficiency 142–4, 206–7

   protein S deficiency 144–5, 206–7

   prothrombin G20210A mutation 137–9, 207–8

   sticky platelet syndrome (SPS) 147–8

thrombosis 134

   anticardiolipins and 149, 156, 157–8, 160–1

   fibrinolytic defects and 145–6

   heparin-induced thrombocytopenia and 560–1

   in disseminated intravascular coagulation 2, 20, 21, 22–3

      management 37–8

      morphological findings 23–5

      significance 2, 21, 25

      see also disseminated intravascular coagulation

   lupus anticoagulants and 149, 150–1

   mortality 201

   pathophysiology 341

   placental 250, 259–60

      intervillous thrombi 261

      massive subchorial thrombosis 261

      see also placenta

   pregnancy and 341–4

      hemostatic changes in pregnancy 202, 342–3

      incidence 200

   thrombogenesis 342

   thrombotic defects associated with recurrent miscarriage 56–7

      procoagulant defects 58–9

   see also deep vein thrombosis (DVT); pulmonary embolism (PE); thrombophilia in pregnancy; venous thromboembolism

thrombotic thrombocytopenic purpura (TTP) 497–9

   etiology 497–8

   management 499

      plasma exchange (PE) therapy 499

tissue plasminogen activator (tPA) deficiency 146

TORCH viral infections 261

tranexamic acid

   disseminated intravascular coagulation therapy 40

   menorrhagia treatment

      with factor XI deficiency 580

      with von Willebrand disease 577–8

   post partum hemorrhage management 403–4

transcatheter embolization, post partum hemorrhage management 408–10

transferrin assay 279–80

transfusion-transmitted diseases (TTD) 529–30

trophotropism 258


umbilical cord 258

   aberrant membranous vessel 258

   controlled cord traction 391–2

   furcate cord 258

   hemangiomas 258–9

   marginal or membranous insertion 258

umbilical vessels

   sickle cell disease and 445

   traumatic tears 261

uremic bleeding 91

   management 539–40

urinary output, post partum hemorrhage monitoring 406

uterine artery ligation 414

uterine cancer

   venous thrombosis risks 310, 316

   see also malignancy

uterine contractions 390

   post partum hemorrhage management 403

      prevention 390–1, 392

uterine massage 392

uterine packing 412

uterotonic agents 390–1, 403


vaginal tamponade 412

vascular coils 409

vasopressors, post partum hemorrhage management 404–5

   monitoring 407

venous thromboembolism (VTE)

   management guidelines in pregnancy 352

      at risk patients 352

      patients already receiving anticoagulation 353

      patients at risk for pregnancy loss 353–5

      patients with mechanical heart valves 353

   prophylaxis in cancer patients 310–11

      during chemotherapy 326–7, 332–3

      during radiotherapy 320

      during surgery 315–19, 331–2

      recommendations 331–3

      with central venous catheters 328–31, 333

   risk factors 311–14

      risk-assessed model (RAM) 311, 312

   risk in malignancy 310, 311

      age and 312–13, 314–19

      during cancer surgery 313, 314, 315–19

      during chemotherapy 320–7, 324–5

      during radiotherapy 319–20

      influencing factors 311–14

      with central venous catheters 327–31

   see also deep vein thrombosis (DVT); pulmonary embolism (PE); thrombosis

ventilation-perfusion scan

viral infection, disseminated intravascular coagulation and 18

vitamin B12 284–5

   deficiency

      diagnosis 287–9

      hematological sequelae 290–1

      neural tube defects and 293

      neuropsychiatric symptoms 291

      treatment 295–6

   homocysteine interrelationship 285–6

   requirements in pregnancy 290

von Willebrand disease (VWD) 83–91, 386–8, 574–8

   acquired von Willebrand syndrome (aVWS) 87

   classification 84–7, 387, 484–5

      Type 1 84–5

      Type 2A 85

      Type 2B 86

      Type 2M 86

      Type 2N 86–7

      Type 3 87

   diagnosis 86, 87–8, 387, 485, 576

      prenatal diagnosis 485

   factor VIII: C deficiency comparison 388

   inheritance patterns 484–5

   management

      during pregnancy 88–91, 386–8, 539

      with menorrhagia 576–8

   menorrhagia and 571–2, 574–8

      treatment 576–8

   prevalence 574–6

   surgical considerations 582–3

von Willebrand factor (VWF) 83–4

   in thrombotic thrombocytopenic purpura 497–8

   replacement therapy 88–9, 90–1

   stimulant therapy 89–90


warfarin treatment

   factor V Cambridge mutation 137

   factor V Leiden mutation 135

   lupus anticoagulant thrombosis syndrome 155

   menorrhagia and 581

   protein C deficiency 143

   protein S deficiency 144

   reversal of warfarin effect 537–8

   venous thrombosis prophylaxis

      during chemotherapy 326–7

      with central venous catheters 328–31, 333


X-linked inheritance 473

ximelagatran 355


© Cambridge University Press


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