Maternal Anemia and Coagulation/Fibrinolysis after Fetoscopic Laser Photocoagulation for Twin-to-Twin Transfusion Syndrome
| Autor: | Satoshi Kawaguchi, Takashi Yamada, Hidemichi Watari, Kinuko Nakagawa, Mamoru Morikawa, Ami Hosokawa-Miyanishi, Kentaro Chiba, Takeshi Umazume, Kazutoshi Cho |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Anemia medicine.medical_treatment Gestational Age Hematocrit Twin-to-twin transfusion syndrome Gastroenterology Monochorionic Diamniotic Twin Pregnancy Postoperative Complications Pregnancy Internal medicine D-dimer Fibrinolysis medicine Humans Retrospective Studies Laser Coagulation medicine.diagnostic_test Cesarean Section business.industry Fetoscopy Obstetrics and Gynecology Fetofetal Transfusion Blood Coagulation Disorders medicine.disease Pulmonary embolism Pregnancy Complications Reproductive Medicine Pregnancy Twin Gestation Female business |
| Zdroj: | Gynecologic and Obstetric Investigation. 84:477-484 |
| ISSN: | 1423-002X 0378-7346 |
| DOI: | 10.1159/000499913 |
| Popis: | Aim: This study was performed to evaluate maternal changes in laboratory characteristics after fetoscopic laser photocoagulation (FLP) for twin-to-twin transfusion syndrome (TTTS). Methods: A retrospective review was conducted among 30 women with monochorionic diamniotic twin pregnancy with TTTS who underwent FLP at 16–26 weeks of gestation. Maternal laboratory parameters were measured before and after FLP. Results: The pre-FLP mean hemoglobin level (10.0 g/dL), hematocrit level (30.0%), platelet count (229 × 109/mL), fibrinogen level (461 mg/dL), and antithrombin activity (96.8%) decreased after FLP (8.5 g/dL, 25.5%, 204 × 109/mL, 403 mg/dL, and 83.6%, respectively) and returned to normal spontaneously within 2 weeks (9.6 g/dL, 29.4%, 293 × 109/mL, 460 mg/dL, and 102.4%, respectively). The D-dimer level before FLP (2.41 μg/mL) increased after FLP (4.28 μg/mL), and the elevated level was maintained for 2 weeks (3.24 μg/mL). The symptomatic venous thromboembolism (VTE) was not detected after FLP in any of the 30 patients. However, one woman had pulmonary embolism after subsequent cesarean section. Conclusion: Changes in maternal anemia and coagulation/fibrinolysis after FLP for TTTS returned to normal spontaneously within 2 weeks. Maternal elevation of D-dimer level after FLP might be a warning indicator of VTE. |
| Databáze: | OpenAIRE |
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