P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK Color: 1C ind BLBK321-Paidas September 7, 2010 15:9 Trim: 244mm X 172mm

Index

Note: Italicized f and t refer to figures and tables, respectably.

Abciximab, 207 anti-A, 29 ABO blood group, 28–9 anti-B, 29 ABO hemolytic disease, 29 anti-c, 28 acetaminophen, 45 anticoagulant therapy, 111–43 acidosis, 197 antiplatelet agents, 141 acquired thrombophilia, 68–74. See also low molecular weight heparin, 127–30, inherited thrombophilia 140–41 diagnosis of, 68, 72t for mechanical heart valve incidence of, 68 thromboprophylaxis, 138–43 obstetrical complications, 73 unfractionated heparin, 127, 140–41 pathogenecity, 71 for venous thromboembolism, 111–18 pathophysiology of, 71 for venous thromboembolism in pregnancy, activated partial thromboplastin time (aPTT), 118–36 127, 173 vitamin K antagonists, 139–40 activated protein C (APC), 6, 74–9, 191 anti-D immunoglobulin, 33 activated recombinant factor VII (rFVIIa), 165 antenatal, 33 activation markers, 7 dose regime, 35 acute fatty liver of pregnancy (AFLP), 187 indications for RhD-negative mothers, 35 acute leukemia, 20 antifibrinolytic drugs, 202 ADAMST13 deficiency, 44 anti-Kell, 28 adenosine diphosphate (ADP), 60, 61–2 f antiphospholipid antibody syndrome (APAS), adherent placenta, 169–70 68–74 alpha-delta storage pool deficiency, 165 clinical consequences, 72–3 Alport syndrome, 60 diagnosis of, 68, 72t amegakaryocytic thrombocytopenia, 60 incidence of, 68 amniotic fluid embolism (AFE), 184–5 obstetrical complications, 73 anaphylaxis, 211 pathogenicity, 71 anemia, 2–3, 12–13. See also red cell disorders pathophysiology of, 71 aplastic, 20 antiplatelet agents, 141 diagnosis, 21–4 antithrombin etiology, 14 changes in pregnancy, 5t of infection, 19 deficiency, 75–6t, 84–6 iron-deficiency, 13–15, 14t, 21–2 in disseminated intravascular coagulation, management in pregnancy, 24–5 189, 191 megaloblastic, 15–16, 23–4 replacement, in preeclampsia, 86–9 parasitic disease, 18 COPYRIGHTEDaplastic anemia, 20 MATERIAL pathophysiology during pregnancy, 13–14 argatroban, 131 postpartum hemorrhage and, 168 arterial embolization, 177–8 prevalence, 12 Ascaris lumbricoides,18 red cell membrane disorders, 19–20 Asherson’s syndrome, 74 renal, 19 aspirin, 88, 91, 92–9t sickle cell disease, 17–18 atonic uterus, 176 thalassemia, 16–17, 23 anemia-induced coagulopathy, 197 B lymphocytes, 4 Ankylostoma duodenale,18 Bacillus cereus, 210 antenatal anti-D prophylaxis, 33 Bakri balloon, 175

216 P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK Color: 1C ind BLBK321-Paidas September 7, 2010 15:9 Trim: 244mm X 172mm

Index 217

balloon tamponade, 175–6 coagulation, 5 basophil count, 4 coagulopathy, 199–206 Bernard-Soulier syndrome, 60 antifibrinolytic drugs, 202 beta thalassemia, 17 blood component therapy, 200 bleeding disorders, inherited, 153–9 blood transfusion support in, 199–200 antenatal care, 158 clinical/laboratory evidence of, 199 care during labor, 158–9 cryoprecipitate, 201 in gynecology, 161–5 dilutional, 199 hemophilia, 156–7 rFVIIa therapy for, 202–6 platelet function disorders, 164–5 fresh frozen plasma, 201 and pregnancy, 157–8 massive blood transfusion in, 199–200, 201–2 prenatal diagnostic, 158 platelets, 200 von Willebrand disease, 153–6, 162–3 colloids, 172 blood component therapy, 200 complete blood count (CBC), 21 blood groups, 28 compression ultrasound leg vein imaging, blood loss, 170–71 116–17 blood transfusion, 195–214 congenital amegakaryocytic thrombocytopenia, acute transfusion reactions, 210–11 60 acute hemolytic reaction, 210 consumption coagulopathy, 197 allergic reactions, 211 contaminated blood, transfusion of, 210 anaphylaxis, 211 cordocentesis, 52 febrile non-hemolytic transfusion cryoprecipitate, 201 reactions, 211 crystalloids, 171–2, 190 fluid overload, 210–11 CT pulmonary angiography, 115, 126 transfusion contaminated blood, 210 cytokines, 183–4 administration, 209 cytotoxic drugs, 20 blood warmers, 209 cytotrophoblasts, 67 compatibility procedures, 208 complications, 212 dalteparin, 97t, 130 delayed hemolytic transfusion reaction, 212 danaparoid, 131 post-transfusion purpura, 213 D-dimer, 112, 115, 122, 189 transfusion associate graft-versus-host decidualization, 68 disease, 212 deep vein thrombosis (DVT), 111 transfusion-related acute-lung injury, 212 clinical prediction rules, 117t complications of, 209–10 diagnostic tools, 116–17, 121–4 group and cross match, 208 clinical assessment, 116 infections from, 213–14 compression ultrasound leg vein imaging, infection screening, 213 116–17, 122 malaria, 213–14 venography, 116, 122 variant Creutzfeldt-Jacob disease, 213–14 in pregnant women, 122–4 infusion rates for blood components, 208–9 delayed hemolytic transfusion reaction (DHTR), infusion times for blood components, 208–9 212 intrauterine, 37–8 delta storage pool deficiency, 165 intravenous access, 209 desmopressin acetate (DDAVP), 155–6, 163 massive, 200 dextran, 190 in non-emergency situations, 207 Diego antigen system, 31t in planned surgery, 207–8 dilutional coagulopathy, 199 planning, 208 discrete membranous subaortic stenosis, support, 199–200 severity assessment, 198 blood warmers, 209 disseminated intravascular coagulation (DIC), 182–92 caesarian section, 55, 169 acute fatty liver of pregnancy, 187 cardiolipin antibodies, 5t amniotic fluid embolism and, 184–5 catastrophic antiphospholipid syndrome blood and blood products, 190–91 (CAPS), 74 clinical diagnosis of, 187–8 chlorpheniramine, 211 eclampsia and, 185 chondromalacia punctata, 129 etiological factors, 184 chondroplasia punctata, 140 fluid choices, 189 chorioamnionitis, 174 general principles, 183–4 chronic myeloid leukemia, 20 intrauterine death and, 186 citrate phosphate dextrose, 38 intrauterine infections and, 186–7 P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK Color: 1C ind BLBK321-Paidas September 7, 2010 15:9 Trim: 244mm X 172mm

218 Index

disseminated (Cont.) fluid resuscitation, 171, 198–9 laboratory diagnosis of, 188–9 folate, 3 anti-thrombin levels, 189 folate deficiency, 15–16 D-dimer, 189 folic acid, 19 fibrin degradation product, 188–9 fondaparinux, 46, 131–2 fibrinogen, 188 fresh frozen plasma (FFP), 158t, 173, 190, 201, partial thromboplastin time, 188 209 PF 1+2 assay, 189 FV Leiden mutation, 185 platelet count, 188 thrombin time, 188 gelatin, 190 management of, 189 genital tract trauma, 169 pathophysiology, 183–4 Gerbich antigen system, 32t placental abruption and, 185–6 gestational thrombocytopenia, 41, 47t,57 role of antithrombin III in, 191 Gestosis Index (GI), 86–7 use of activated protein C, 191 Group B streptococci, 210 use of rVIIa in, 192 group O blood, 29 disseminated intravascular coagulopathy (DIC), gynecologic surgery, 137–8 20 Dombrock antigen system, 32t HAMP gene, 15 Duffy antigen system, 31t Hartmann’s solution, 190 Hb-E beta thalassemia, 17 eclampsia, 185 HELLP syndrome, 20, 44, 47t, 173, 185 elevated factor VII, 75t helminths, 18 elevated factor VIII, 75t hematocrit, 2 elevated factor XI, 75t hematologic changes, pregnancy-associated, 1–8 ELISA assays, 113–14 activation markers, 7 enoxaparin, 91, 96–7t anemia in pregnancy, 2–3 Eptifibatide, 207 coagulation, 5 ergometrine, 170, 174 factorX,6 erythrocytes, 2 folate requirements, 3 erythropoietin, 2 hemostatic changes in pregnancy, 5t Escherichia coli, 210 iron requirements, 3 plasma volume, 1–2 factor IX, 156 platelet counts, 4 factor V deficiency, 158t protein S, 6 factor V Leiden (FVL), 74–9, 75–6t protein Z, 6–7 factor VI deficiency, 158t red blood cells, 2 factor VIII, 155 resistance to activated protein C, 6 factor X, 6 thrombocytopenia, 4 factor X deficiency, 158t white blood cells, 4 factor Xa, 6 hematological malignancies, 20 factor XI deficiency, 158t hemoglobin, 2–3, 15 factor XIII deficiency, 158t hemoglobinopathies, 16–18 Fanconi anemia, 59 sickle cell anemia, 17–18 febrile reactions, 211 thalassemia, 16–17 ferritin, 13, 15 hemolytic disease of the newborn (HDN), 28–38 fetal blood sampling, 54 ABO hemolytic disease, 29 fetal intervention for, idiopathic, 57 blood groups and, 28 fetal platelet typing, 51–2 characteristics of, 28 fetal thrombocytopenia, 46–8. See also maternal incidence of, 28 thrombocytopenia isoimmunization and, 28–9 characteristics of, 59t pattern and severity, 28–9 genetic disorders associated with, 58–60 Rhesus hemolytic disease, 30–38 gestational, 57 hemolytic uremic syndrome, 43–5, 47t immunologic causes, 57 hemophilia, 156–7. See also inherited bleeding infectious etiologies, 58 disorders neonatal alloimmune thrombocytopenia, antenatal care, 157 48–57 care during labor, 157 fever, 211 causes of, 156 fibrin degradation products (FDP), 183, 188–9 prenatal diagnosis of, 156–7 fibrinogen, 5t, 188 hemophiliacs, 202 P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK Color: 1C ind BLBK321-Paidas September 7, 2010 15:9 Trim: 244mm X 172mm

Index 219

hemorrhage, postpartum, 167–79 antithrombin deficiency, 84–6 balloon tamponade for, 175–6 factor V Leiden resistance, 74–9 blood loss estimation, 170–71 hyperhomocysteinemia, 81–3 consequences of, 168 methyltetrahydrofolate reductase mutations, definition of, 167–8 81–3 etiology, 168–9 PAI-1 4G/5G mutation, 89–90 evaluation of, 195–6 protein C deficiency, 83–4 immediate management of, 171–4 protein S deficiency, 83 incidence of, 167 prothrombin gene mutation, 79–81 management of, 195–6, 206–7 inhibitor-1, 5t medical management of, 174–5 internal iliac artery ligation (IAL), 177 mortality rate, 167 intrauterine death, 186 obstetric hemorrhage, 195 intrauterine infections, 186–7 prevention of, 169–70 intrauterine transfusion, 37–8 recurrence of, 168 intravenous gamma globulin (IVGG), 52–3 risk factors, 168 iron deficiency anemia secondary, 167–8, 206–7 diagnosis, 21–2 surgical management of, 176–8 in pregnancy, 13–15, 14t arterial embolization, 177–8 iron requirements, 3 hysterectomy, 178 isoimmunization, 28–9 pelvic devascularization, 176–7 uterine compression sutures, 176 kallikrein, 183 hemosiderin, 15 Kell antigen system, 31–2t heparin-induced thrombocytopenia, 45–6, 47t, Kidd antigen system, 32t 127 kinins, 183 hepcidin, 15 HIV infection, 19, 47t lepirudin, 131 hookworm infection, 18 leukemia, 20 hormone replacement therapy, 136–7 low-molecular-weight heparin (LMWH), HPA-1a antigen, 48–9 127–9 HPA-4 antigen, 48 complications, 128–9 HPA-5b antigen, 48 in gynecologic surgery, 137–8 hydrops fetalis, 28, 30 monitoring, 128 hydroxyurea, 20 precautions, 128 hyperhomocysteinemia, 81–3 for pulmonary embolism, 117–18 hyperkalemia, 201 safety for fetus/infant, 128–9 hypocalcemia, 201 for venous thromboembolism, 117–18, hypochromic red blood cells (HRBCs), 16, 140–41 21–2 hypothermia, 173, 197, 209 magnetic resonance venography (MRV), 122 hypovolemia, 171, 190 malaria, 16, 18, 213–14 hypovolemic shock, 196 massive blood transfusion hysterectomy, 161, 178, 196 in coagulopathy, 199–200 risks in, 201 idiopathic thrombocytopenic purpura (ITP), maternal thrombocytopenia, 41–6. See also fetal 41–2, 47t,57 thrombocytopenia iliac artery ligation (IAL), 177 gestational thrombocytopenia, 41 imatinib mesylate, 20 HELLP syndrome, 41 infection, anemia of, 19 hemolytic uremic syndrome, 43–5 inherited bleeding disorders, 153–9 heparin-induced thrombocytopenia, 45–6 antenatal care, 158 HIV infection, 45 care during labor, 158–9 idiopathic thrombocytopenic purpura, in gynecology, 161–5 42–3 hemophilia, 156–7 preeclampsia, 41 platelet function disorders, 164–5 thrombotic thrombocytopenic purpura, and pregnancy, 157–8 43–5 prenatal diagnostic, 158 May-Hegglin anomaly, 60 von Willebrand disease, 153–6, 162–3 mean corpuscular hemoglobin (MCH), 16 inherited thrombophilia, 74. See also acquired mechanical heart valve thromboprophylaxis, thrombophilia 131–2, 138–43 activated protein C resistance, 74–9 antiplatelet agents, 140–41 P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK Color: 1C ind BLBK321-Paidas September 7, 2010 15:9 Trim: 244mm X 172mm

220 Index

mechanical heart valve thromboprophylaxis parasitemia, 18 (Cont.) partial thromboplastin time, 188 low molecular weight heparin, 140–41 parvovirus B19 infections, 58 in pregnant women, 138–9 peak systolic activity (PCV), 36–7 antepartum period, 143 pelvic devascularization, 176–7 peripartum period, 143 PF 1+2 assay, 189 postpartum period, 143 pheniramine, 211 prepregnancy counseling, 142 Philadelphia chromosome, 20 unfractionated heparin, 140–41 placenta, adherent, 169, 170 vitamin K antagonists, 139–40 placenta accreta, 196 megaloblastic anemia, 15–16. See also anemia; placenta previa, 170, 195 red cell disorders placental abruption, 185–6, 195 diagnosis, 23–4 plasma volume, 1–2 folate deficiency in, 15–16 plasminogen activator inhibitor-1 (PAI-1), 5t, malaria and, 16 89–90, 182 vitamin B12 deficiency in, 16 plasminogen activator inhibitor-2 (PAI-2), 5t, menorrhagia, 161–2 182 platelet function disorders and, 164–5 platelet counts, 3, 5t, 188 von Willebrand disease and, 162–3 platelet function disorders, 164–5 methyltetrahydrofolate reductase (MTHFR), categories, 164 81–3 diagnosis, 164–5 A1298C polymorphism, 82 incidence of, 164 C677T allele frequency, 82 menorrhagia and, 164–5 microcytic anemia, diagnosis of, 24 f treatment of, 164–5 misoprostol, 169–70, 174–5 platelet storage pool deficiency, 165 modified antigen capture elisa (MACE), 51 platelet transfusion, 173 monocyte count, 4 platelets, 200, 209 postpartum hemorrhage (PPH), nadroparin, 96t 167–79 nasal hypoplasia, 140 balloon tamponade for, 175–6 nematodes, 18 blood loss estimation, 170–71 neonatal alloimmune thrombocytopenia. See consequences of, 168 also maternal thrombocytopenia definition of, 167–8 neonatal alloimmune thrombocytopenia etiology, 168–9 (NAIT), 48–57 evaluation of, 195–6 causes of, 48 fluid resuscitation, 171 definition of, 48 immediate management of, 171–4 fetal blood sampling and, 54 incidence of, 167 pregnancies at risk, 51 management of, 195–6, 206–7 prenatal evaluation, 49–51 massive, 167, 172 f women with no personal/family history, medical management of, 174–5 49–50 mortality rate, 167 women with persona/family history, 50–51 obstetric hemorrhage, 195 prenatal management, 51–7 pathophysiology of hemostatic failure in, fetal blood sampling, 54 196–7 fetal platelet typing, 51–2 prevention of, 169–70 medical interventions, 52–7 recurrence of, 168 risk stratification, 56–7 risk factors, 168 severity of, 48 secondary, 167–8, 206–7 non-steroidal anti-inflammatory drugs surgical management of, 176–8 (NSAIDs), 163 arterial embolization, 177–8 Novoseven, 175 hysterectomy, 178 pelvic devascularization, 176–7 obstetric hemorrhage, 195 uterine compression sutures, oral anticoagulants, 118 176 oral contraceptive pills (OCP), 136–7, 163 post-transfusion purpura, 213 osteoporosis, 135 prednisone, 53, 92t oxytocin, 170 preeclampsia, 41 antithrombin replacement in, 86–9 PAI-1 4G/5G mutation, 89–90 clinical features, 47t pancytopenia, 20 differential diagnosis, 44 P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK Color: 1C ind BLBK321-Paidas September 7, 2010 15:9 Trim: 244mm X 172mm

Index 221

disseminated intravascular coagulation and, mode of action, 202–3 185 monitoring effect of, 206 platelet transfusion for, 173 preconditions for administration, 204–5 pregnancy recommendations for use of, 204 activation markers, 7 repeat dosage, 206 acute fatty liver of, 187 safety of, 203 anemia in, 2–3 surgical hemostasis, 205 coagulation in, 5 treat of coagulopathic bleeding with, 202–3 factorXin,6 recombinant erythropoietin (rhEPO), 19, 22 folate requirements in, 3 recombinant FVIIa, 175, 192 hematologic changes in, 1–8 red blood cells, 2, 209 hemostatic changes in pregnancy, 5t red cell disorders, 12–26 iron requirements in, 3 acute leukemia, 20 normal coagulation during, 182 anemia of infection, 19 plasma volume in, 1–2 aplastic anemia, 20 platelet counts in, 4 chronic myeloid leukemia, 20 protein S in, 6 hematological malignancies, 20 protein Z in, 6–7 iron deficiency anemia, 14–15, 21–2 red blood cells in, 2 malaria, 18 resistance to activated protein C, 6 megaloblastic anemia, 15–16, 23–4 thrombocytopenia in, 4 red cell membrane disorders, 19–20 white blood cells in, 4 renal anemia, 19 preimplantation factor, 67 sickle cell disease (SCD), 17–18 preimplantation genetic diagnosis, 157 thalassemia, 16–17, 23 prekallikrein, 183 red cell membrane disorders, 19–20 primigravida, 168 red cell transfusion, 172–3 progesterone, 163 renal anemia, 19 prostaglandin, 174 renal transplant patients, 208 protein C, 5t renin activity, 1–2 protein C deficiency, 75–6t, 83–4 reticuloendothelial (RE) cells, 15 protein S, 5t,6 Retrovir, 19 protein S deficiency, 75–6t, 83, 185 rFVIIa, 192 protein Z, 5t,6–7 Rh blood group, 28 protein Z dependent protease inhibitor (ZPI), Rhesus antigen system, 31t 182 Rhesus hemolytic disease, 30–34. See also prothrombin, 6, 76t hemolytic disease of the newborn (HDN) prothrombin complex, 5t Doppler assessment of fetal MCA PSV, 36–7 prothrombin gene mutation (PGM), 79–80, 185 dose regime for anti-D, 35 G20210A, 76t early detection, 30 obstetric complications and, 80–81 incidence of, 30 prothrombin mutation, 75t indications for anti-D immunoglobulin in prothrombin time, 173 RhD-negative mothers, 35 prothrombin time ratio (PTR), 199 intrauterine transfusion, 37–8 Pseudomonas sp., 210 management of, 36 pulmonary angiography, 112 mortality rate, 30 pulmonary embolism (PE), 111 non-RhD antibodies, 31–2t clinical prediction rules, 113t prophylaxis, 30–33 diagnostic tools antenatal anti-D, 33 clinical assessment, 112 anti-D immunoglobulin, 33 CT pulmonary angiography, 115, 126 RhD unsensitized pregnancies, 30–31 D-dimer, 113–14 RhD-sensitized pregnancies, 31 pulmonary angiography, 114 re-testing at 28-30 weeks, 34–5 ventilation perfusion scanning, 114–15, screening for, 34–5 124–6 sensitizing events, 33–4 in pregnant women, 124–6 Ringer’s lactate, 171, 190 ristocetin cofactor, 155 recombinant activated factor VII (rFVIIa), 202–6 rituximab, 45 administration guidelines, 205 Rusch urological hydrostatic balloon, 175 contraindications, 205 first dose, 206 Scianna antigen system, 32t indications for, 204 selectin E (ELAM-1), 183 P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK Color: 1C ind BLBK321-Paidas September 7, 2010 15:9 Trim: 244mm X 172mm

222 Index

Sengstaken-Blackmore esophageal catheter, activated protein C resistance, 74–9 175 anticoagulation trials, 91t serine proteases, 197 antiphospholipid antibody syndrome, 68–73 serum transferrin receptor (sTfR), 21–2 factor V Leiden resistance, 74–9 sickle cell disease (SCD), 17–18 inherited, 74 “snowman sign”, 44 issues, 71t Staphylococcus aureus, 210 management during pregnancy, 90–101 Staphylococcus epidermis, 210 maternal and fetal surveillance during syncytiotrophoblasts, 67 pregnancy, 101 syntocinon, 174 risk factors, 70t screening, 90 T lymphocytes, 4 thrombophilia, inherited, 74 tamponade, 175–6 activated protein C resistance, 74–9 thalassemia, 16–17, 23 antithrombin deficiency, 84–6 thrombin time, 188 factor V Leiden resistance, 74–9 thrombin-activatable fibrinolysis inhibitor hyperhomocysteinemia, 81–3 (TAFI), 182 methyltetrahydrofolate reductase mutations, thrombin-antithrombin (TAT) complexes, 182 81–3 thrombocytopenia, 4 PAI-1 4G/5G mutation, 89–90 characteristics of, 47t protein C deficiency, 83–4 fetal, 46–8 protein S deficiency, 83 gestational, 41 prothrombin gene mutation, 79–81 HELLP syndrome, 41 thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome, 43–5 43–5, 47t idiopathic thrombocytopenic purpura, 41–2 Tirofibam, 207 infection, 45 tissue factor pathway inhibitor (TFPI), 182 medical, 42–5 tissue factor (TF), 69 f , 202–3 neonatal alloimmune, 48–57 tissue plasminogen activator (TPA), 131 pharmacologic, 45–6 transfusion associate graft-versus-host disease preeclampsia, 41 (TA-GvHD), 212 pregnancy-related, 41 transfusion-related acute-lung injury (TRALI), thrombotic thrombocytopenic purpura, 43–5 212 thrombocytopenia, fetal, 46–8 transxemic acid, 158t, 163 characteristics of, 59t Trichuris trichiura,18 genetic disorders associated with, 58–60 trimethoprim-sulfamethoxazole, 45 gestational, 57 tumor necrosis factor, 187 immunologic causes, 57 tyrosine kinase inhibitor, 20 infectious etiologies, 58 neonatal alloimmune thrombocytopenia, unfractionated heparin, 140–41 48–57 for venous thromboembolism, 137–8 thrombocytopenia, neonatal alloimmune, urticaria, 211 48–57 uterine compression sutures, 176 causes of, 48 uterus, atonic, 176 definition of, 48 fetal blood sampling and, 54 variant Creutzfeldt-Jacob disease (vCJD), pregnancies at risk, 51 213–14 prenatal evaluation, 49–51 venography, 116, 122 women with no personal/family history, venous thromboembolism (VTE), 111–18 49–50 deep vein thrombosis, 111 women with persona/family history, 50–51 diagnostic tools, 112–17 prenatal management, 51–7 epidemiology, 111–12 fetal blood sampling, 54 etiology, 112 fetal platelet typing, 51–2 in gynecology, 136–8 medical interventions, 52–7 epidemiology, 136 risk stratification, 56–7 etiology, 136 severity of, 48 gynecologic surgery for, 137–8 thrombocytopenia-absent radius (TAR) hormonal therapy for, 136–7 syndrome, 58 prevention, 136–8 thrombomodulin, 186 risk factors, 136 thrombophilia, 67–8, 133–4 management of, 117–18 acquired, 68–74 ovarian cysts, fetal, 111 P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK Color: 1C ind BLBK321-Paidas September 7, 2010 15:9 Trim: 244mm X 172mm

Index 223

prevention of, 118 pulmonary embolism, 124–6 pulmonary embolism, 111 risk factors, 119–20 risk factors, 112 thrombolytic therapy for, 131 risk factors for, 70t,75t ventilation perfusion scanning, venous thromboembolism (VTE) in pregnancy, 114–15 118–36 vitamin B12 deficiency, 16 alternative anticoagulants for, 131–2 vitamin K antagonists, 139–40 deep vein thrombosis (DVT), 122–4 von Willebrand disease (vWD), 153–6. See also diagnosis, 120–26 inherited bleeding disorders epidemiology, 118 antenatal care, 155 etiology, 119–20 DDAVP administration, 155–6, 163 incidence of, 119 diagnosis, 154, 163 management of, 126–31 labor, 155 evidence-based, 126 menorrhagia and, 162 immediate management, 126, 130 postnatal, 155–6 long-term, 131 in pregnant women, 154–6 low molecular weight heparin, 127–9 prenatal diagnosis of, 154 peripartum, 130 prevalence, 153 postpartum, 131 treatment of, 163 unfractionated heparin, 127 types of, 153, 162–3 mortality rate, 119 von Willebrand factor (vWF), prevention of, 132–6 127 antepartum period, 132 postpartum prophylaxis, 134–6 warfarin, 129–30 prior VTE, 132–3 white blood cells, 4 thrombophilia, 133–4 Wiskott-Aldrich syndrome, 60