PFM.58 Diagnosis and treatment of fetal Kasabach Merritt syndrome
Bibliographic record
Abstract
Introduction Kasabach-Merritt Syndrome (KMS) is a rare complication of a vascular tumour resulting in consumptive coagulopathy, anaemia and thrombocytopenia. While haemangiomas are common tumours of the first year of life, KMS has rarely been described in fetal life. The aim of this study was to review cases of fetal KMS in order to meaningfully study this rare, complex and devastating complication. Methods Retrospective cohort of all fetal KMS in a large tertiary level unit in Toronto (1992–2013), with literature review of all cases of fetal KMS. Results Two cases of fetal KMS were identified in this unit and twelve on review of the literature. On reviewing all fourteen cases, the median gestational age of diagnosis was 31 weeks (14–37 weeks) and median GA of delivery of 34 weeks (30–39 weeks). Seven affected fetuses underwent fetal blood sampling (FBS). Eleven infants were delivered by caesarean section, with one vaginal delivery following intrauterine death and two where the prognosis was considered to be dismal; both of these infants died after birth. Five other infants died shortly after delivery despite intensive neonatal care, giving an overall mortality of 57%. Amongst the survivors all required multiple transfusions and intensive neonatal care. One infant required an amputation of the left leg and two infants required surgical resection of the mass after unsuccessful medical treatment. Conclusion KMS is an important but uncommon complication of fetal haemangioma with a high rate of morbidity and mortality.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".