The clinical management of factor XI deficiency in pregnant women
| Autor: | Allison P. Wheeler, David Gailani, Celeste Hemingway |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Factor XI Deficiency Clinical Decision-Making Risk Assessment Article 03 medical and health sciences 0302 clinical medicine Pregnancy Risk Factors medicine Humans Anesthesia Intensive care medicine Factor XI Blood Coagulation Hemostasis postpartum bleeding business.industry Obstetrical bleeding Postpartum Hemorrhage Pregnancy Complications Hematologic Disease Management Hematology Acute bleeding medicine.disease Bleeding diathesis Regional anesthesia 030220 oncology & carcinogenesis Female Blood Coagulation Tests Disease Susceptibility business 030215 immunology |
| Zdroj: | Expert Rev Hematol |
| Popis: | Introduction Factor XI (FXI) deficiency is associated with highly variable bleeding, including excessive gynecologic and obstetrical bleeding. Since approximately 20% of FXI-deficient women will experience pregnancy-related bleeding, careful planning and knowledge of appropriate hemostatic management is pivotal for their care. Areas covered In this manuscript, authors present our current understanding of the role of FXI in hemostasis, the nature of the bleeding phenotype caused by its deficiency, and the impact of deficiency on obstetrical care. The authors searched PubMed with the terms, 'factor XI', 'factor XI deficiency', 'women', 'pregnancy', and 'obstetrics' to identify literature on these topics. Expectations of pregnancy-related complications in women with FXI deficiency, including antepartum, abortion-related, and postpartum bleeding, as well as bleeding associated with regional anesthesia are discussed. Recommendations for the care of these women are considered, including guidance for management of prophylactic care and acute bleeding. Expert commentary FXI deficiency results in a bleeding diathesis in some, but not all, patients, making treatment decisions and clinical management challenging. Currently available laboratory assays are not particularly useful for distinguishing patients with FXI deficiency who are prone to bleeding from those who are not. There is a need for alternative testing strategies to address this limitation. |
| Databáze: | OpenAIRE |
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