Abstract
Background: Consumption coagulopathy during pregnancy is a very rare condition associated with an elevated risk of maternal and neonatal morbidity and mortality. The incidence of pregnancies complicated by leiomyomas is increasing as infertility treatments advance. Degeneration is a complication of leiomyomas during pregnancy. We encountered a leiomyoma degeneration-induced consumption coagulopathy during pregnancy that may have caused fetal periventricular leukomalacia (PVL).
Case presentation: a 42-year-old nulliparous woman with two leiomyomas was admitted to the hospital at 17 weeks and 5 days with leiomyoma degeneration and threatened preterm labour. Blood examination revealed severe inflammation, very low fibrinogenlevels, increased D-dimer levels, and prolonged PT-INR. These data suggested consumption coagulopathy; therefore, fresh frozen plasma (FFP) and dried human fibrinogen were administered, and the patient recovered from consumption coagulopathy. She was discharged once the inflammation improved by 19 weeks of gestation. At 41 weeks, the baby was delivered using forceps because of a non-reassuring fetal status (NRFS). The newborn had severe asphyxia, and magnetic resonance imaging (MRI) on day 6 revealed a PVL. In this case, the timing of the coagulopathy consumption was too early for the development of PVL but the duration from delivery was too short to develop PVL.
Conclusion: Consumption coagulopathy might cause not only acute placental hypoxia, but also chronic placental hypoxia, which might have caused PVL in the most susceptible interval.