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Oberlin A, Krenitsky NM, Gandhi C, Akpan IJ, Eisenberger A, Landau R, Yurteri-Kaplan L, Nathan L, Sheen JJ, LaSala A, D'Alton M. Acquired Hemophilia A: A Rare, Acquired Coagulopathy in the Postpartum Setting. AJP Rep 2023; 13:e85-e88. [PMID: 38033602 PMCID: PMC10684337 DOI: 10.1055/a-2198-7888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 10/19/2023] [Indexed: 12/02/2023] Open
Abstract
Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity. Pregnancy-associated acquired hemophilia A (AHA) caused by autoantibodies against factor VIII can present with recurrent episodes of postpartum bleeding. Case 1 A 50-year-old G2P0112 presented with vaginal bleeding 22 days postcaesarean. She underwent dilation and curettage, hysterectomy, and interventional radiology (IR) embolization before AHA diagnosis. She was hospitalized for 32 days and received 23 units of blood product. She remains without relapse of AHA after 5 years. Case 2 A 48-year-old G3P1021 presented with vaginal bleeding 8 days postcaesarean. She underwent three surgeries and IR embolization before AHA diagnosis. She was hospitalized for 18 days and received 39 units of blood product. Prednisone and cyclophosphamide were continued after discharge. AHA is a rare cause of PPH. An isolated prolonged activated partial thromboplastin time (aPTT) should prompt further workup in postpartum patients with refractory bleeding. Rapid recognition of AHA can prevent significant morbidity related to hemorrhage, massive transfusion, and multiple surgeries.
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Affiliation(s)
- Austin Oberlin
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
| | - Nicole M. Krenitsky
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
| | - Christy Gandhi
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
| | - Imo Joseph Akpan
- Division of Hematology and Oncology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Andrew Eisenberger
- Division of Hematology and Oncology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Ruth Landau
- Department of Anesthesia, Columbia University Irving Medical Center, New York, New York
| | - Ladin Yurteri-Kaplan
- Division of Gynecologic Specialty Surgery, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
| | - Lisa Nathan
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
| | - Jean-Ju Sheen
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
| | - Anita LaSala
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
| | - Mary D'Alton
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York
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Oberlin A, Wallace J, Moore JL, Saleem S, Lokangaka A, Tshefu A, Bauserman M, Figueroa L, Krebs NF, Esamai F, Liechty E, Bucher S, Patel AB, Hibberd PL, Chomba E, Carlo WA, Goudar S, Derman RJ, Koso-Thomas M, McClure EM, Goldenberg RL. Examining maternal morbidity across a spectrum of delivery locations: An analysis of the Global Network's Maternal and Neonatal Health Registry. Int J Gynaecol Obstet 2023; 160:797-805. [PMID: 35949060 PMCID: PMC9911556 DOI: 10.1002/ijgo.14391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 07/07/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To better understand maternal morbidity, using quality data from low- and middle-income countries (LMICs), including out-of-hospital deliveries. Additionally, to compare to the WHO estimate that maternal morbidity occurs in 15% of pregnancies, which is based largely on hospital-level data. METHODS The Global Network for Women's and Children's Health Research Maternal Newborn Health Registry collected data on all pregnancies from seven sites in six LMICs between 2015 and 2020. Rates of maternal mortality and morbidity and the differences in morbidity across delivery location and birth attendant type were evaluated. RESULTS Among the 280 584 deliveries included in the present analysis, the overall maternal mortality ratio was 138 per 100 000, while 11.7% of women experienced at least one morbidity. Rates of morbidity were generally higher for deliveries occurring within hospitals (19.8%) and by physicians (23.6%). The lowest rates of morbidity were noted among women delivering in non-hospital healthcare facilities (5.6%) or with non-physician clinicians (e.g. nurses, midwives [5.4%]). CONCLUSION The present study shows important differences in reported maternal morbidity across delivery sites, with a trend towards lower morbidity in non-hospital healthcare facilities and among non-physician clinicians.
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Affiliation(s)
- Austin Oberlin
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY 10032, USA
| | - Jacqueline Wallace
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 1 Center Dr, Bethesda, MD 20892, USA
| | - Janet L. Moore
- Center for Clinical Research Network Coordination, RTI International, Research Triangle Park, NC, 27709, USA
| | - Sarah Saleem
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Adrien Lokangaka
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Antoinette Tshefu
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | | | - Lester Figueroa
- Instituto de Nutrición de Centroamérica y Panamá, Guatemala City, Guatemala
| | - Nancy F. Krebs
- University of Colorado School of Medicine, Denver, CO, USA
| | | | - Edward Liechty
- Indiana School of Medicine, University of Indiana, Indianapolis, IN, USA
| | - Sheri Bucher
- Indiana School of Medicine, University of Indiana, Indianapolis, IN, USA
| | - Archana B. Patel
- Lata Medical Research Foundation, Nagpur, India
- Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Patricia L. Hibberd
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Elwyn Chomba
- Department of Pediatrics, University Teaching Hospital, Lusaka, Zambia
| | | | - Shivaprasad Goudar
- KLE Academy Higher Education and Research, J N Medical College Belagavi, Karnataka, India
| | | | - Marion Koso-Thomas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 1 Center Dr, Bethesda, MD 20892, USA
| | - Elizabeth M. McClure
- Center for Clinical Research Network Coordination, RTI International, Research Triangle Park, NC, 27709, USA
| | - Robert L. Goldenberg
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, 622 West 168th Street, New York, NY 10032, USA
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Oberlin A, Pasipamire T, Chibwesha C. Exploring women's preferences for HPV-based cervical cancer screening using a discrete choice experiment. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2018.10.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yousufuddin M, Aguilera CC, Oberlin A, Sagar S, Jahangir A. WITHDRAWN: A potential molecular mechanism for digitalis cardiac toxicity in elderly. J Mol Cell Cardiol 2007. [DOI: 10.1016/j.yjmcc.2007.03.866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Inagaki M, Iwashitat N, Hishiyama Y, Kaburagi Y, Yoshida A, Oberlin A, Lafdi K, Bonnamy S, Yamadass Y. Studies on “Mesophase”-Pitch-Based Carbon Fibers. ACTA ACUST UNITED AC 1991. [DOI: 10.7209/tanso.1991.57] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Oberlin A, Bonnamy S, Bourrat X, Monthioux M, Rouzaud JN. Electron Microscopic Observations on Carbonization and Graphitization. ACS Symposium Series 1986. [DOI: 10.1021/bk-1986-0303.ch005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- A. Oberlin
- Laboratoire Marcel Mathieu, Equipe de Recherche du CNRS No. 131, U.E.R. Sciences, Université d'Orleans, 45046 Orleans Cedex, France
| | - S. Bonnamy
- Laboratoire Marcel Mathieu, Equipe de Recherche du CNRS No. 131, U.E.R. Sciences, Université d'Orleans, 45046 Orleans Cedex, France
| | - X. Bourrat
- Laboratoire Marcel Mathieu, Equipe de Recherche du CNRS No. 131, U.E.R. Sciences, Université d'Orleans, 45046 Orleans Cedex, France
| | - M. Monthioux
- Laboratoire Marcel Mathieu, Equipe de Recherche du CNRS No. 131, U.E.R. Sciences, Université d'Orleans, 45046 Orleans Cedex, France
| | - J. N. Rouzaud
- Laboratoire Marcel Mathieu, Equipe de Recherche du CNRS No. 131, U.E.R. Sciences, Université d'Orleans, 45046 Orleans Cedex, France
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Inagaki M, Endo M, Oberlin A, Kimura S, Nakamizo M, Hishiyama Y, Fujimaki H. Structure of a Mesophase Pitch-based Carbon Fiber. ACTA ACUST UNITED AC 1979. [DOI: 10.7209/tanso.1979.130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Oberlin A. Practical electron microscopy in materials science. Vol. 4edited by J. W. Edington. J Appl Crystallogr 1977. [DOI: 10.1107/s0021889877013764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Oberlin A, Terriere G, Boulmier JL. Carbonification, Carbonization and Graphitization as Studied by High Resolution Electron Microscopy. ACTA ACUST UNITED AC 1975. [DOI: 10.7209/tanso.1975.29] [Citation(s) in RCA: 46] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Oberlin A, Terrière G, Boulmier J. Carbonification, Carbonization and Graphitization as Studied by High Resolution Electron Microscopy. ACTA ACUST UNITED AC 1975. [DOI: 10.7209/tanso.1975.153] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Oberlin A, Rousseaux F. Graphitation partielle de quelques carbones durs. Etude en microscopie et microdiffraction electronique. J Appl Crystallogr 1970. [DOI: 10.1107/s0021889870005770] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Oberlin A, Rousseaux F. Graphitation partielle de quelques carbones durs. Etude en microscopie et microdiffraction électroniques. J Appl Crystallogr 1968. [DOI: 10.1107/s0021889868005376] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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