DISSEMINATED INTRAVASCULAR COAGULATION
AbstractBackground: Disseminated Intravascular Coagulation (DIC) is a complex systemic thrombohaemorrhagic disorder characterised by widespread endothelial damage. Aim of this study was to assessthe prevalence of DIC in different obstetrical conditions. Methods: This descriptive study was carriedout in the Department of Obstetrics and Gynaecology Unit ‘A’, Ayub Medical College, Abbottabad fromJanuary 2010 to December 2011. All 40 diagnosed cases of DIC were included, and their risk factors andmaternal/foetal outcome were evaluated. Results: Out of 4,334 obstetrical admissions, DIC wasdiagnosed in 40 (0.92%) patients. Risk factors noted were eclampsia 28 (70%), abruptio placentae 7(17.5%), septicaemia 3 (7.5%), pancytopenia 1 (2.5%), and 1 (2.5%) patient had DIC secondary tohaemorrhagic shock due to placenta previa. Mean age range of patients was 31±6.69 (19–48) year, andparity was 3.17±2.56 (0–10). Mode of delivery of 34 (85%) patients was by caesarean section, andvaginal delivery occurred in 3 (7.5%) patients. Eleven (27.5%) patients had caesarean hysterectomy.Maternal mortality was 25% and perinatal mortality was (47.5%). Majority of our patients were criticaland were managed in ICU. Conclusion: DIC is serious life threatening condition secondary to anyunderlying pathology. There is spontaneous resolution of DIC after correction of pathology.Keywords: DIC, Eclampsia, Abruptio placentae, placenta previa, haemorrhagic shock
Becker JU. Disseminated intravascular coagulation: Follow-up.
available at: emedicine.medscape.com/article/199627-overview.
[accessed on 23-1-2011]
Bangal V, Kwarta A, Gulati P. Management of Dissemination
intravascular coagulation by aggressive component therapy: A
case report. Pravara Med Rev 2010;5(1):33–6.
Thachil J, ToH CH. Disseminated intravascular coagulation n
obstetrical disorders and its acute haematological management.
Blood Rev 2009;23:167–76.
Ratho R, Butt NF, Iqbal A, Khan MZ. Complications and
outcome of patients of pre-eclampsia and eclampsia presenting to
Medical Wards of Mayo Hospital Lahore. Ann King Edward Med
Ahmed FA, Amin A, Naeem NK. HELLP Syndrome, A clinical
variant of pre-eclampsia. Ann King Edward Med Uni
Kansaria JJ, Parulerkar SV. Critical care in Pre-eclampsiaEclampsia. Bombay Hosp J 2008;50(1):19–25.
Harram K, Svenden E, Abildgaard U. The HELLP syndrome:
Clinical issues and management a Review. Biomed Central
Nisa Q, Memon H, Ali M. Frequency, maternal and fetal outcome
of abruption placenta in a Rural Medical College Hospital, Mirpur
Khas Sind. Pak J Med Sci 2010;26(3):663–6.
Khooharo Y, Memon FA, Noorani KJ. Diseminatioed
intravascular coagulation in Abruptio Placentae. Pak J Med Sci
Hossain N, Khan N, Sultana SS, Khan N. Abruptio placenta and
adverse pregnancy outcome. J Pak Med Assoc 2010;60(6):443–6.
Nisar N, Sohoo NA. Emergency Peripartum Hysterectomy:
Frequency, Indications and Maternal Outcome. J Ayub Med Coll
Bardale RV, Dixit PG. Pregnancy-related deaths: A Three-year
retrospective study. Indian Acad Forensic Med 2006;32(1):15–8.
Yenicesu GI, Kol IO, Yenicesu C, Cetin A. HELLP (emolysis,
elevated liver enzymes, and low platelets) syndrome. Cumhuriyet
Med J 2009;31:182–8.