Volume 263, Number 3, 126-130, DOI: 10.1007/s004040050010

Disseminated intravascular coagulopathy in pregnancy: thorough comprehension of etiology and management reduces obstetricians’ stress

S. Lurie, M. Feinstein and Y. Mamet

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Abstract

In pregnancy and puerperium disseminated intravascular coagulopathy may accompany abruptio placenta, intrauterine fetal demise with retained dead fetus, amniotic fluid embolism, endotoxin sepsis, preecalampsia with HELLP and massive transfusion. Clinical signs and symptoms of DIC can include oozing from venupuncture sites and/or mucous membranes, red cell lysis from activation of the complement system, hemorrhage from coagulopathy and possible uterine atony, hypotension from hemorrhage and/or bradykinin release, and oliguria from end-organ insult and hypovolemia/hypotension. Treatment of DIC consists of replacement of volume, blood products, and coagulation components and cardiovascular and respiratory support with elimination of underlying triggering mechanism.

Key words Disseminated intravascular coagulopathy - Pregnancy - Abruptio placenta - Intrauterine fetal demise - Amniotic fluid embolism

Received: August 1998 / Accepted: 10 May 1999

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