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Diagnosis and treatment of bbstetrics disseminated intravascular coagulation in resource limited settings

Helen C Okoye1, Theresa U Nwagha1, Angela O Ugwu1

  • 1Department of Haematology and Immunology, College of Medicine, University of Nigeria Ituku Ozalla campus, Enugu.

African Health Sciences
|August 29, 2022
PubMed

Insights

Disseminated intravascular coagulation (DIC) in pregnancy is challenging in resource-limited settings. Obstetricians primarily use platelet counts for diagnosis and fresh blood for treatment, facing financial constraints for frequent monitoring.

Area of Science:

  • Obstetrics
  • Hematology
  • Global Health

Background:

  • Disseminated intravascular coagulation (DIC) is a frequent cause of obstetric bleeding.
  • Managing DIC is particularly challenging in resource-limited settings (RLS).

Purpose of the Study:

  • To investigate Nigerian obstetricians' diagnostic and treatment practices for obstetric DIC.
  • To identify challenges in managing DIC in RLS.

Main Methods:

  • A semi-structured questionnaire was administered to 171 Nigerian obstetricians.
  • Data collected included demographics and practices for diagnosing and treating obstetric DIC.

Main Results:

  • Preeclampsia (70.2%) and postpartum hemorrhage (58.3%) were the most common causes of DIC.
  • Platelet count (95.9%) was the most utilized diagnostic test; antithrombin assay (20.6%) was least used.
  • Fresh whole blood was the preferred treatment (approx. 75%), with monitoring limited by patient finances.

Conclusions:

  • DIC diagnosis and management remain challenging in RLS, particularly regarding investigations and monitoring.
  • Low index of suspicion for non-overt DIC may be a contributing factor.
Abstract

Keywords:
DICInvestigationsObstetriciandiagnosistreatment

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