Hematology and Oncology Book


Coagulopathy in Pregnancy

Aka: Coagulopathy in Pregnancy, Pregnancy Related Coagulopathy
  1. Labs: Coagulation studies
    1. ProTime (PT)
    2. Partial Thromboplastin Time (PTT)
    3. Fibrin split products (Fibrin Degradation Products)
    4. Fibrinogen
    5. Clot Test (4-8 minutes is normal clotting time)
  2. Management: General
    1. Specific underlying Coagulopathy cause
    2. Replace Fluids
    3. Replace Coagulation deficits
  3. Management: Fresh Frozen Plasma (1 unit) Indications
    1. Fibrinogen <100 mg/dl
      1. FFP 1 unit increases Fibrinogen 10 mg/dl
    2. Partial Thromboplastin Time (PTT) >60
    3. ProTime >18 (INR >3)
    4. Following every 5-6 Platelets transfused
    5. Following every 4-8 units packed RBCs transfused
  4. Management: Packed Red Blood Cell (1 unit) Indications
    1. Hematocrit below 27 to 30%
    2. One unit packed RBC will increase Hematocrit 3%
    3. Consider Fresh Frozen Plasma after 4-8 pRBC units
  5. Management: Platelet (1 unit) Indications
    1. Platelets <50,000
    2. Platelets 1u will increase Platelets 5-10,000
    3. Consider Fresh Frozen Plasma after 5-6 Platelet units

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