Risk Factors Associated with Development of Disseminated Intravascular Coagulation (DIC) in Obstetrical Cases.

Area of Science:

• Obstetrics and Gynecology
• Hematology
• Critical Care Medicine

Background:

• Disseminated intravascular coagulation (DIC) is a life-threatening condition with high maternal mortality rates globally.
• In pregnancy, DIC is a critical obstetric emergency, often stemming from coagulation cascade overactivation leading to microvascular thrombosis and organ dysfunction.
• Also known as consumption coagulopathy, DIC presents as severe bleeding disorders.

Purpose of the Study:

• To investigate the specific obstetrical risk factors contributing to the development of DIC in pregnant women.
• To identify common clinical presentations and outcomes associated with DIC in an obstetric population.

Main Methods:

• A descriptive, cross-sectional study involving 300 pregnant women diagnosed with DIC at Dhaka Medical College Hospital from January 2020 to December 2022.
• Data collection included detailed patient history, clinical examinations, and relevant investigations to identify obstetrical risk factors.
• Statistical analysis was performed using SPSS version 22.0.

Main Results:

• Abruptio placenta (34.0%), postpartum hemorrhage (PPH) (27.0%), and preeclampsia/eclampsia (22.0%) were significant risk factors for DIC.
• Hypertension (72.0%), antepartum hemorrhage (45.3%), and PPH (38.7%) were frequently observed comorbidities.
• Maternal mortality was 12.0% and perinatal mortality was 24.3%.

Conclusions:

• Obstetrical complications such as abruptio placenta, PPH, and hypertensive disorders are major drivers of DIC in pregnancy.
• High rates of maternal and perinatal mortality underscore the severity of DIC in obstetric cases.
• Prompt recognition and effective management strategies are crucial for improving outcomes in pregnant women with DIC.