Schwere geburtshilfliche Hämostasedefekte: Diagnostik und therapeutisches Vorgehen

: We evaluated 21 pregnant patients with severe disorders of haemostasis by retrospective chart analyses, 15 patients were treated with intravenous heparin (10.000 to 20.000 I.U.) during and after surgery. Eighteen of 21 patients developed renal failure and 8 died. Postoperative bleeding complications making laparotomies mandatory occurred in 10 patients. These bleeding complications are seen in relation to the heparin treatment instituted immediately after surgery. We do not favor the administration of heparin during the immediate obstetrical postoperative period, the more as Antithrombin III-concentrate is now available. Surgical intervention in order to achieve haemostasis is of paramount therapeutic importance. Drainage of infections remains furthermore the most important task in those obstetrical emergency cases where infections play a predominant role. To maintain or to re-establish the normovolemic perfusion ameliorates the rheological conditions which should monitored with care.