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Disseminated intravascular coagulation.

E A Letsky1

  • 1Imperial College School of Medicine, Queen Charlotte's Hospital, Hammersmith Hospitals Trust, Hammersmith House, 2nd Floor, Du Cane Road, London, W12 0HS, UK.

Best Practice & Research. Clinical Obstetrics & Gynaecology
|August 2, 2001
PubMed
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Pregnancy causes hypercoagulable states, increasing risks for venous thromboembolism and disseminated intravascular coagulation (DIC). Managing DIC in pregnancy requires addressing the underlying trigger, not just correcting coagulation deficits.

Area of Science:

  • Obstetrics
  • Hematology
  • Pathophysiology

Background:

  • Pregnancy induces a hypercoagulable state, increasing risks for thromboembolic disorders.
  • Disseminated intravascular coagulation (DIC) in pregnancy is a secondary complication, often triggered by conditions like abruptio placentae, amniotic fluid embolism, pre-eclampsia, sepsis, or hemorrhagic shock.

Purpose of the Study:

  • To elucidate the pathophysiology and management of hemostatic disorders in pregnancy.
  • To highlight the importance of identifying and managing the primary trigger in obstetric coagulopathies.

Main Methods:

  • Review of the hemostatic system's changes during pregnancy.
  • Analysis of common triggers for DIC in obstetric patients.
  • Discussion of diagnostic markers for low-grade DIC in pre-eclampsia.

Related Experiment Videos

  • Outline of initial management strategies for massive obstetric hemorrhage.

    • Main Results:

    • The hemostatic system shifts towards hypercoagulability in pregnancy, predisposing to venous thromboembolism and DIC.
    • Common triggers for DIC include abruptio placentae, amniotic fluid embolism, pre-eclampsia, sepsis, and hemorrhagic shock.
    • Initial management of obstetric hemorrhage is consistent regardless of initial coagulopathy.
    • Low-grade DIC associated with pre-eclampsia can be monitored using platelet counts and fibrin degradation products (FDPs).

    Conclusions:

    • Successful management of obstetric coagulopathies hinges on addressing the underlying cause.
    • Supportive measures and removal of the triggering factor are crucial for managing DIC in pregnancy.
    • Outcomes are primarily determined by the effective management of the trigger, not direct correction of coagulation deficits.