Clinical and therapeutic correlations in consumption coagulopathy of obstetric acute renal failure

Heparin has been proposed following the supposed role of disseminated intravascular coagulation (DIC) in the pathologies associated with the consumption coagulopathies such as obstetric acute renal failure (ARF), whilst antifibrinolytic agents could be advocated to stop a simultaneous triggered fibrinolysis. Out of 26 obstetric ARF DIC may be demonstrated in 10 and supposed in 6 patients who developed severe post-partum uterine bleeding. Therapeutic schedules employing heparin or antifibrinolytic agents early post-partum do not seem to change either the behaviour of laboratory parameters (showing a DIC partial resolution within 48 hours), or heavy bleeding in respect to the patients treated with supportive therapies alone. Furthermore, heparin administered during the following days does not seem to be a crucial factor in the renal recovery, and is often followed by severe haemorrhagic complications. Fresh frozen plasma after aprotinin is able to stop bleeding in the presence of persisting signs of consumption without damaging renal recovery.