Late puerperal hemorrhage of a patient with Klippel-Trenaunay syndrome: A case report

Medicine (Baltimore). 2019 Dec;98(50):e18378. doi: 10.1097/MD.0000000000018378.

Abstract

Introduction: The Klippel-Trenaunay syndrome (KTS) is a rare congenital disorder. The obstetric course of women with KTS varies. Complications include bleeding, disseminated intravascular coagulation (DIC), thromboembolic events, etc. PATIENT CONCERNS:: Here, we report a case of late puerperal hemorrhage of a Chinese puerpera with KTS. The repeating severe hemorrhage, the DIC, and the Kasabach-Merrit syndrome made the treatment more difficult.

Diagnosis: KTS is a mixed malformation with a vascular component that is characterized by abnormal development of veins, capillaries, and lymphatics. Our patient was first diagnosed with KTS at the last trimester of pregnancy.

Interventions: Massive infusion of blood products, two laparotomies, as well as bilateral internal iliac artery embolization was carried out.

Outcomes: Although the patient survived from the life-threatening hemorrhage, she lost her uterus forever.

Conclusion: An interdisciplinary cooperation of obstetrician, anesthesiologist, vascular surgeon, and intensive care physician is highly recommended. Prophylactic anticoagulation is generally advised in the gestational and postpartum period.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blood Transfusion
  • Female
  • Humans
  • Hysterectomy
  • Klippel-Trenaunay-Weber Syndrome / complications*
  • Klippel-Trenaunay-Weber Syndrome / physiopathology
  • Postpartum Hemorrhage / etiology
  • Postpartum Hemorrhage / therapy*
  • Pregnancy