A CLINICAL CASE OF A SUCCESSFUL TREATMENT OF FETAL GROWTH RESTRICTION IN A WOMAN WITH ANTIPHOSPHOLIPID SYNDROME AND SUBCHORIONIC HEMATOMA (CLINICAL ANALYSIS OF A PATIENT’S CARD)
DOI:
https://doi.org/10.11603/24116-4944.2024.1.14737Keywords:
subchorionic hematoma, antiphospholipid syndrome, pregnancyAbstract
The aim of the study – to describe the successful completion of a clinical case in a pregnant woman with the formation of a large subchorionic hematoma (SCH) in the second trimester of pregnancy and antiphospholipid syndrome (APS) using clinical instrumental and laboratory tests, as well as improving the algorithm for providing medical care.
Materials and Methods. The examination of the patient L., 28 years old, was carried out from the moment of the formation of a SCH measuring 115x30mm at the term gestation 17 weeks and 5 days. The clinical research involves general research methods; coagulogram test; express method of visual assessment of platelet aggregation; quantitative determination of soluble fibrin-monomer complexes (SFMCs); lupus anticoagulant tests (LA), cardiolipin antibodies and β2 glycoprotein in blood serum. Also, it involves the instrumental methods of examination – ultrasonography of pelvic organs; thromboelastography (TEG).
Results and Discussion. Thrombocytopenia of the unknown etiology, which was accompanied by an impaired platelet function, led to the increased consumption of thrombin – the main agonist of platelet function, the formation of a thrombophilia state, and, as a result, the occurrence of vaginal bleeding with the formation of SCH. Detection of LA, analyzed in the blood coagulation test, in the average titer, became the reason for prescribing low molecular weight heparin (LMWH) in prophylactic dosage.
Conclusions. The comprehensive approach in the diagnosing of disorders of the hemostasis system in pregnant women at second trimester who have a large SCH, and their examination for APS (when an increased coagulation potential is detected) – can contribute to a successful carrying full term pregnancy.
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