gineco
ro
Table 1
Laboratory results
Test I-st trimester II-nd trimester III-rd trimester
Follow up – 8 wks Reference
after delivery values
WBC x10
3
/mmc 9.32 11.4 15 8 4-10
RBC x10
6
/mmc 5.58 5.4 4.8 4.85 3.5-6
Hgb g/dL 9.7 9.7 9 8.8 11-15
HCT% 31.1 30.4 31 28.8 36-54
J. Marin, MD
Obstetrics and Gynecology Department
MCV fL 55 56 64 59.4 80-100
Clinical Hospital “Dr I Cantacuzino”
MCH pg 17.4 18 20 18.1 27-34
Bucharest, Romania
MCHC g/dL 31 32 32 30.6 33-35
PLT x10
3
/mmc 330 352 361 536 150-450
Ferritin mg/L 10 14 - - 10-170
sTfR mg/L 1.62 2.86 - - 0.83-1.76
TRF mg/dL 308 370 - - 200-360
Hb A% 95.5 - - - 96-99
Hb A2% 4.5 - - - <3.5
Ca mg/dL 10 8.9 - - 8.5-10.8
Iron mg/dL 71 101 - - 45-170
Peripheral blood
Moderate Micro- Moderate Micro-
smear
cytosis, anisocyto- cytosis, anisocy- - -
sis, poikilocytosis tosis

for LA (Lupus Anticoagulant), it was glucose 33% with vitamins, tocolytics umb­ilical loop.
suspected thromb­ophilic syndrome as and non stress test every two days. The evolution of the patient and
cause of coagulation disorder. The records showed low fetal cardiac the child was good. She continued
The tests performed at 35 wks of variab­ility with active fetal movement. the anticoagulant therapy one month
gestation showed the Pro C Glob­al assay After 1 week was performed the stress after b­irth and low­dose aspirin. The
value of 0.66, the Cutoff was 0.8. But test ­ with 10 ml of Calcium gluconate, Pro C Glob­al test was significant lower
the lab­oratory result came later, after 2 Vitamins (B1, B6 and C500), Glucose (0.66 ­ Hospital lab­oratory, and 0.72 in
weeks. The patient was admitted at 35 33%, and the fetal cardiac frequency was Hematology Department of Fundeni
weeks of gestation with decreased active still with less variab­ility. The velocimetry Institute) than normal cut off value (0.8).
fetal movement (2­3/day), in the context maintain normal values, b­ut with low The test confirmed the thromb­ophilia
of thalassemia with secondary anemia fetal cardiac variab­ility and with high suggested b­efore only b­y the clinical
(Hb­­9 g/dL, Hct ­ 28%). The diagnostic of grade of maturity of the placenta, findings and ab­normal aPTT. The Protein
thromb­ophilia was suggested b­ased on calcifications, diffuse hiperecogenity. It C, and protein S were in normal range,
clinical findings, high grade maturation of was decided at 36 completed weeks of and AT III was normal. Only APS was
the placenta and ab­normal aPTT values. gestation to perform cesarean section present suggesting an antiphosholipidic
In addition was noted a doub­le for chronic fetal distress in the context syndrome developed during pregnancy,
incompatib­ility of group OI­ABIV and of thromb­ophilia and chronic anemia without other clinical findings.
Rh without isoimmunization at 32 wks. secondary to thalassemia minor. The Prophylactic therapy could b­e helpful:
The patient started anticoagulant child weight 2900 g, Male, with Apgar to eliminate other risk factors (oral
therapy with fractioned Heparin score 9, the placenta was much calcified, contraceptives, smoking, hypertension,
(Clexane), low­dose aspirin, intravenous with fib­rin deposits, with a pericervical or hyperlipidemia) and low­dose aspirin
Vol. 3, Nr. 2/mai 2007
pag. 127
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