Prenatal and peripartum management of congenital afibrinogenaemia

We experienced three cases and four successful deliveries with congenital a fibrinogenaemia and propose the following guidelines for the prenatal and p eripartum management: (i) genital bleeding usually begins at 5 weeks' gesta tion and spontaneous abortion always occurs at 6-8 weeks' gestation without fibrinogen infusion: (ii) the fibrinogen level must be at least 0.60 g/l a nd, if possible, higher than 1.0 g/l during the pregnancy; (iii) the necess ary amounts of fibrinogen increase as the pregnancy progresses and the pret erm labour occurs; (i ir) the fibrinogen level under the continuous infusio n of fibrinogen during labour must be at least 1.5 g/l and, if possible, hi gher than 2.0 g/l to prevent placental abruption: (v) the puerperium is usu ally uneventful with a reduced dose of fibrinogen infusion.