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Maternal and Fetal Outcomes in Disseminated Intravascular Coagulation Cases Associated with Pregnancy Complications
Insights
The pregnancy-modified disseminated intravascular coagulation (DIC) score is crucial for predicting outcomes in obstetric emergencies. Underlying conditions significantly impact prognosis, guiding clinical management and improving patient outcomes.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Critical Care Medicine
Background:
- Disseminated intravascular coagulation (DIC) poses a high risk in obstetric conditions.
- A pregnancy-modified DIC score is used to assess risk in these scenarios.
- Understanding the link between underlying disease and DIC score is vital for prognosis.
Purpose of the Study:
- To investigate the relationship between the pregnancy-modified DIC score and underlying obstetric conditions.
- To evaluate the impact of the underlying disease on prognosis in patients with high DIC scores.
- To compare maternal and neonatal outcomes based on the cause of DIC.
Main Methods:
- Study included obstetric patients with a DIC score ≥ 26.
- Conditions included obstetric bleeding, placental abruption, and preeclampsia/HELLP syndrome.
- Comparison of laboratory results, maternal morbidity/mortality, and neonatal outcomes based on underlying disease.
Main Results:
- The incidence of DIC score ≥ 26 was 0.14% (224/154,233 deliveries).
- Preeclampsia/HELLP syndrome group showed lower platelets, lower prothrombin time, and higher fibrinogen compared to obstetric hemorrhage/placental abruption groups.
- Lower rates of blood transfusion and hysterectomy were observed in the preeclampsia/HELLP syndrome group.
Conclusions:
- Underlying disease is a critical factor in predicting prognosis for obstetric DIC.
- The pregnancy-modified DIC score aids in diagnosis and risk stratification.
- Tailoring management based on the underlying cause improves patient outcomes.
Background:
The relationship between the pregnancy modified DIC score, which is applied in obstetric conditions where the risk of disseminated intravascular coagulation is high, and underlying disease, as well as its effect on the prognosis, was investigated.
Methods:
Those with a DIC score ≥ 26 from obstetric conditions, such as obstetric bleeding, placental abruption, or preeclampsia/HELLP syndrome, which are at high risk of developing DIC, were included in the study. These patients were compared in terms of laboratory results, maternal morbidity/mortality, and neonatal outcomes, according to the underlying disease.
Results:
The DIC score was ≥ 26 in 224 of 154,233 deliveries in our center, and the incidence was 0.14%. In the preeclampsia/HELLP syndrome group, the platelet count and prothrombin time were lower, and the fibrinogen level was higher than those of the obstetric hemorrhage and placental abruption groups. In addition, the rates of blood transfusion and hysterectomy were lower in women who developed DIC due to pre-eclampsia/HELLP syndrome than in those with obstetric hemorrhage.
Conclusions:
Considering the underlying disease is an important factor in predicting prognosis, when using the new pregnancy modified diagnostic scores for DIC diagnosis.
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