Hematology/oncology clinics of North America
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Hematol. Oncol. Clin. North Am. · Oct 2000
ReviewHemorrhagic problems in obstetrics, exclusive of disseminated intravascular coagulation.
During pregnancy many physiologic changes occur that result in an increase in coagulation factors and a decrease in fibrinolytic activity. Because hemorrhage during pregnancy is a major cause of maternal morbidity, it is important to recognize and understand the pathophysiology of hereditary and acquired bleeding disorders. This article reviews von Willebrand's disease types 1, 2, and 3 and acquired hemophilia.
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Hematol. Oncol. Clin. North Am. · Oct 2000
ReviewSyndromes of disseminated intravascular coagulation in obstetrics, pregnancy, and gynecology. Objective criteria for diagnosis and management.
This article presents current understanding of the causes, pathophysiology, clinical, and laboratory diagnosis, and management of fulminant and low-grade DIC, as they apply to obstetric, pregnant, and gynecologic patients. General medical complications leading to DIC, which may often be seen in these patients, are also discussed. Considerable attention has been given to interrelationships within the hemostasis system. ⋯ Also, therapy must be highly individualized according to the nature of DIC, patient's age, origin of DIC, site and severity of hemorrhage or thrombosis, and hemodynamic and other clinical parameters. Finally, many syndromes that are often categorized as organ-specific disorders and are sometimes identified as independent disease entities, such as AFE syndrome, HELLP syndrome, adult shock lung syndrome, eclampsia, and many others, either share common pathophysiology with DIC or are simply a form of DIC. These entities represent the varied modes of clinical expression of DIC and illustrate the diverse clinical and anatomic manifestations of this syndrome.