Abstract Number: PB2552
Meeting: ISTH 2020 Congress
Background: Postpartum hemorrhage (PPH) is the leading cause of maternal death worldwide. The incidence of inherited bleeding disorders in women with PPH is not well established. Hence, knowing such conditions may improve the maternal prognosis.
Aims: The aim of this study is to establish the prevalence of chronic hemostasis disorders discovered in primagravida with severe immediate PPH in the Tunisian population
Methods: It is a transversal study including all primagravida parturiant in our delivery unit who presented with severe immediate PPH (estimated blood loss> 1000 ml) during a 2 years period (01/07/2017- 30/06/2019). Women with known pre existant inherited blood disorders were excluded. Platelet aggregation and ATP release were performed using different agonists (ADP, Collagen, Arachidonic Acid and Epinephrin. Ristocetin was used to assess platelet agglutination. Levels of coagulation factors, including factor XIII were assessed by ROTEM analysis. All blood samples were taken at the time of the diagnosis of severe PPH and 3 months after delivery.
Results: During the study, 25 694 women delivered in our unit from whom 32% primagravida. From the 8 222 primagravida, 21% had PPH and 6% severe PPH (493 patients). The mean age of this group was 26 +/- 5.82. An inherited blood disorder was already diagnosed in 29 patients from whom only 3 were in the severe PPh group.
The prevalence of hemostasis disorders in primagravida with severe PPH in our population was 29% (96% platelet function abnormalities, 12% VWD and 12% coagulation factors deficiency). The blood sample results were concordant in each patient at the time of delivery and 3 months after in 95% of the cases. A factor VII deficiency was only noticed in 4 cases.
Conclusions: The first delivery in asymptomatic young women is a challenge for the hemostasis of the parturient and severe PPH may be secondary to a chronic unknown hemostasis disorder.
To cite this abstract in AMA style:Kaabia O, Letaief F, Skouri H. Hemostasis Disorders in Tunisian Women with Severe Post Partum Heamorrage : A Case Control Pilot Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/hemostasis-disorders-in-tunisian-women-with-severe-post-partum-heamorrage-a-case-control-pilot-study/. Accessed September 21, 2023.
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