• E Aygören-Pürsün, I Martinez Saguer, E Rusicke, F Louwen, F Geka, V Ivaskevicius, J Oldenburg, T Klingebiel, and W Kreuz.
• Department of Pediatric Hematology, Oncology and Hemostasis, Johann Wolfgang Goethe University Hospital, Frankfurt am Main, Germany. eap@em.uni-frankfurt.de
• Am. J. Hematol. 2007 Apr 1;82(4):317-20.

AbstractWithout 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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