A Case Report of Disseminated Intravascular Coagulation After Intrauterine Fetal Demise

Disseminated intravascular coagulation (DIC) is a rare, life-threatening complication of pregnancy in which a hypercoagulable state develops secondary to the contact of tissue factor with circulating blood and causes widespread abnormal clotting. This pathological process disrupts normal blood flow, which can cause multi-organ dysfunction and is associated with very high maternal morbidity and mortality. Occurring in two phases, DIC begins with overactive clotting, which leads to the formation of blood clots within the vessels, and ultimately, the overactive clotting process uses up the body's stores of platelets and clotting factors. The most common obstetric cause of DIC is placental abruption, but other common causes include the hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome and amniotic fluid embolism. The management of DIC involves the administration of antibiotics in the setting of severe sepsis, emergent delivery in the case of placental abruption, and transfusions of packed red blood cells (PRBCs), platelets, and plasma as needed for patients with active bleeding and unstable labs. As evidenced in this case, timely recognition and treatment of the underlying cause of DIC is imperative in improving patient outcomes. Here, we present a case of a 37-year-old G3P2 32w3d female who experienced placental abruption, resulting in intrauterine fetal demise, subsequently leading to DIC.