Disseminated intravascular coagulation in pregnancy – Clinical phenotypes and diagnostic scores

During a women's life cycle, pregnancy is a period in which she is at risk for hemorrhagic events and obstetrical syndromes that may develop into disseminated intravascular coagulation (DIC). This life-threatening condition is a complication of obstetrical and non-obstetrical causes including: (1) acute peripartum hemorrhage (uterine atony, cervical and vaginal lacerations, and uterine rupture); (2) placental abruption; (3) Pre-eclampsia/HELLP syndrome; (4) retained stillbirth; (5) sepsis; (6) amniotic fluid embolism; and (7) acute fatty liver of pregnancy. Acute obstetrical hemorrhage is one of the leading causes for DIC in pregnancy and is one of the most avoidable etiologies of maternal death. In order to develop a common language among physicians a novel pregnancy specific DIC scoring system was developed and point of care testing is currently being validated for utilization in pregnant women. The current review will present the underlying mechanisms, diagnostic scores and, in brief, a therapeutic approach for DIC in pregnancy.