Epidural analgesia in pregnant with deficit of factor VII.

The congenital deficit of FVII of coagulation it's an anomaly of genetic transmission autosomal recessive type, it can occur with clinical manifestations like hematomas and spontaneous bleeding or not. The normal levels of FVII it's found between 70%-130% of the laboratory reference value. For unknown reasons there is a poor correlation between levels of FVII and bleeding risk. During pregnancy coagulation can be significantly altered, there is a no clear consensus and a very few information about how to act during labor in a patient with a FVII deficit. The case of a 35-year-old patient with 35 weeks of gestation and congenital deficit of the coagulation FVII (36%) is presented, epidural analgesia is performed during labor previously administering activated recombinant FVII (rFVIIa) without complications (Spinal hematoma, postpartum bleeding, thrombosis).

Analgesia epidural en gestante con déficit del factor VII / Epidural analgesia in pregnant with deficit of factor VII

El déficit congénito del factor VII (FVII) de la coagulación es una anomalía de transmisión genética de tipo autosómico recesivo, puede presentarse con manifestaciones clínicas como hematomas y sangrados espontáneos o no. Los niveles normales del FVII se encuentran entre el 70-130% del valor de referencia del laboratorio. Por razones desconocidas existe una pobre correlación entre los niveles del FVII y el riesgo de sangrado. Durante el embarazo se puede alterar notablemente la coagulación, no existe un consenso claro y hay escasa información sobre cómo actuar durante el trabajo de parto en paciente con déficit del FVII. Se presenta el caso de una mujer de 35 años en la semana 35 de gestación y déficit congénito del FVII (36%), se realiza analgesia peridural durante el parto administrando previamente factor VII recombinante activado (rFVIIa) sin complicaciones (hematoma peridural, sangrado posparto, trombosis).(AU)

The congenital deficit of FVII of coagulation it's an anomaly of genetic transmission autosomal recessive type, it can occur with clinical manifestations like hematomas and spontaneous bleeding or not. The normal levels of FVII it's found between 70%-130% of the laboratory reference value. For unknown reasons there is a poor correlation between levels of FVII and bleeding risk. During pregnancy coagulation can be significantly altered, there is a no clear consensus and a very few information about how to act during labor in a patient with a FVII deficit. The case of a 35-year-old patient with 35 weeks of gestation and congenital deficit of the coagulation FVII (36%) is presented, epidural analgesia is performed during labor previously administering activated recombinant FVII (rFVIIa) without complications (Spinal hematoma, postpartum bleeding, thrombosis).(AU)

Epidural analgesia in pregnant with deficit of factor VII. / Analgesia epidural en gestante con déficit del factor VII.

The congenital deficit of FVII of coagulation it's an anomaly of genetic transmission autosomal recessive type, it can occur with clinical manifestations like hematomas and spontaneous bleeding or not. The normal levels of FVII it's found between 70%-130% of the laboratory reference value. For unknown reasons there is a poor correlation between levels of FVII and bleeding risk. During pregnancy coagulation can be significantly altered, there is a no clear consensus and a very few information about how to act during labor in a patient with a FVII deficit. The case of a 35-year-old patient with 35 weeks of gestation and congenital deficit of the coagulation FVII (36%) is presented, epidural analgesia is performed during labor previously administering activated recombinant FVII (rFVIIa) without complications (Spinal hematoma, postpartum bleeding, thrombosis).

Actuación ante una lesión percutanea contaminada con sangre / Managemetn of blood-contaminated percutaneous injury

Analizamos en este artículo las normas fundamentales para la prevención de las punciones accidentales por parte de los trabajadores sanitarios, así como los pasos a seguir una vez que se ha producido la punción accidental

In the current paper we have assessed the main guidelines for prevention of accidental puntures by helthcare workers as well s the recommended steps to follow once the punture has occurred

Implicaciones anestésicas en los pacientes portadores de la variante termolábil de la enzima metilén tetrahidrofólico reductasa (MTHFR) / Anesthetic implications for patients with the thermolabile variant of the methylenetetrahydrofolate reductase gene

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Anestesia y vitamina B12 / No disponible

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Consideraciones sobre la nueva guía de fármacos inhibidores de la hemostasia y anestesia regional neuroaxial / On the new guidelines for inhibitors of hemostasis and regional neuraxial

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Uso de la vía subcutánea para la administración de vitamina B12 / Use of the subcutaneous pathway for administering vitamin B12

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Seguimiento de los valores de antitrombina en mujeres en tratamiento anticonceptivo oral / Monitoring of antithrombin levels in women on oral contraceptive treatment

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Anemia perniciosa, trombocitopenia idiopática e hipotiroidismo autoinmune / Pernicious anaemia, idiopathic thrombocytopenic purpure and autoimmune hypothyroidism

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Anticonceptivos orales y riesgo de enfermedad tromboembólica venosa / Oral contraceptives and risk of vein thromboembolic disease

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Anticonceptivos orales y trombofilia congénita / Oral contraceptives and congenital thrombophilia

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[Antiphospholipid antibodies in asymptomatic pediatric patients]. / Anticuerpos antifosfolípido en población pediátrica asintomática.

BACKGROUND: Findings of prolonged activated partial thromboplastin time (APTT) and lupus anticoagulant are rare in asymptomatic children and are often preceded by certain types of surgery. Clinical behaviour is usually favorable. PATIENTS AND METHODS: We assessed the biological and clinical features of antiphospholipid antibodies found in 13 children diagnosed between January 1996 and September 2000 (mean age at diagnosis: 5 years). The patients were prospectively followed-up for a median of 16 months (range: 15-60). The diagnosis of lupus anticoagulant was based on the guidelines of the International Society of Thrombosis and Hematosis and included coagulation-based assays as well as enzyme-linked immunosorbent assay for anticardiolipin and anti-beta 2 glycoprotein I. RESULTS: In all patients lupus anticoagulant was detected after investigation of prolonged APTT prior to surgery (adenoidectomy in eight patients, orchidopexy in one and eye surgery in one). The antibody was associated with infectious mononucleosis in one patient and was detected during routine laboratory investigations in two. All antibodies were primary and 53.6% of events were transient. In all patients lupus anticoagulant IgG and anti-beta 2 glycoprotein I were negative. Slightly reduced factor XII:C plasma concentrations (mean: 38.2 UI/dl) were found in 30.7% of the patients. No clinical manifestations of antiphospholipid symptoms were associated with the diagnosis of antiphospholipid antibodies and none of the patients experienced bleeding after surgery. CONCLUSIONS: Primary antiphospholipid antibodies were infrequent in asymptomatic pediatric patients and were typically associated with certain types of surgery (adenoidectomy, tonsillectomy) or viral infections. They were usually transient and clinically irrelevant. These antibodies may be associated with slightly reduced plasma concentrations of factor XII and consequently a differential diagnosis with a mild factor XII deficiency should be considered.