Preeclampsia complicated with hypofibrinogenemia: 2 case reports and review of the literature

BMC Pregnancy Childbirth. 2023 Sep 1;23(1):631. doi: 10.1186/s12884-023-05965-z.

Abstract

Background: Preeclampsia complicated with hypofibrinogenemia is a rare disorder. We report two cases of severe preeclampsia complicated with hypofibrinogenemia followed by postpartum haemorrhage (PPH).

Case: Two women diagnosed as preeclampsia and hypofibrinogenemia developed severe PPH after undergoing Cesarean sections. Besides supplement with fibrinogen concentrate and supportive treatment, the second patient got administration of heparin after delivery and bleeding was stopped. The haemorrhage in case 1 didn't disappear until an hysterectomy. The two patients both recovered and were discharged soon.

Conclusions: Severe preeclampsia patients with hypofibrinogenemia could suffer PPH. It's necessary to detect and master coagulation function. Heparin could be considered to balance hypercoagulation and hypocoagulation to avoid catastrophic haemorrhage and hysterectomy.

Keywords: Heparin; Hypofibrinogenemia; Postpartum haemorrhage (PPH); Preeclampsia.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Afibrinogenemia* / complications
  • Female
  • Fibrinogen / therapeutic use
  • Heparin
  • Humans
  • Postpartum Hemorrhage* / etiology
  • Postpartum Hemorrhage* / therapy
  • Pre-Eclampsia*
  • Pregnancy

Substances

  • Fibrinogen
  • Heparin