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Evaluation of obstetrical patients with disseminated intravascular coagulopathy - tertiary center experience
Serdar Başaranoğlu1, Mehmet Sıddık Evsen2, Elif Ağaçayak2
1a Department of Obstetrics and Gynecology , School of Medicine, Fatih University , Istanbul , Turkey .
Insights
Obstetric patients with disseminated intravascular coagulopathy (DIC) face high mortality. Urea levels and DIC scores are key predictors of mortality in these cases, aiding prognosis.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Critical Care Medicine
Background:
- Disseminated intravascular coagulopathy (DIC) is a serious condition that can arise from obstetric complications.
- Obstetric DIC is associated with significant mortality and morbidity rates.
Purpose of the Study:
- To investigate the causes of DIC in obstetric patients.
- To identify parameters for predicting mortality in obstetric patients with DIC.
Main Methods:
- Retrospective analysis of 56 obstetric patients diagnosed with DIC between July 2006 and December 2013.
- Inclusion criteria: patients diagnosed with DIC during or after delivery.
Main Results:
- Overall mortality rate for obstetric DIC was 25%.
- Mortality was significantly higher in patients with a DIC score > 5 (40.7%) compared to those with a score ≤ 5 (10.7%).
- International normalized ratio (INR) and urea levels were identified as significant factors affecting mortality (OR: 8.44 and 1.05, respectively).
Conclusions:
- Obstetric conditions can lead to DIC, a syndrome with high mortality.
- Urea levels are a critical factor influencing mortality in obstetric DIC.
- The DIC score can serve as a valuable prognostic tool for predicting outcomes.
Objective:
The purpose of the present study is twofold: (a) to investigate the etiology of disseminated intravascular coagulopathy (DIC) caused by obstetrical conditions and (b) to present parameters that can be used in predicting DIC-related mortality in obstetrical patients.
Material And Method:
Obstetrical patients who had a delivery at or were referred (after delivery) to Obstetrics and Gynecology Clinic of Dicle University between July 2006 and December 2013 were retrospectively analyzed in this study. Those patients diagnosed with DIC were included in the study.
Results:
Fifty-six obstetrical patients carrying the diagnosis of DIC were included in this study. The overall mortality rate was 25% among these patients. More specifically, the mortality rate was 10.7% among patients with a DIC score ≤5 and 40.7% among those with a DIC score > 5. Multiple logistic regression analysis resulted in the finding that international normalized ratio (INR) and urea were among those factors affecting mortality in obstetrical DIC [OR: 8.44 (CI: 1.9-36.8), OR: 1.05 (CI: 1.0-1.1), respectively].
Conclusion:
DIC is a syndrome that might be caused by obstetrical conditions. It is associated with high mortality and morbidity rates. In obstetrical DIC, urea is the most important factor affecting mortality. In addition, we are of the opinion that DIC score might guide mortality predictions as a determinant of prognosis.
