Disseminated intravascular coagulation in pregnancy: Insights in pathophysiology, diagnosis and management

Offer Erez, Salvatore Andrea Mastrolia, Jecko Thachil

Research output: Contribution to journalReview articlepeer-review

62 Scopus citations

Abstract

Disseminated intravascular coagulation (DIC) is a life-threatening situation that can arise from a variety of obstetrical and nonobstetrical causes. Obstetrical DIC has been associated with a series of pregnancy complications including the following: (1) acute peripartum hemorrhage (uterine atony, cervical and vaginal lacerations, and uterine rupture); (2) placental abruption; (3) preeclampsia/eclampsia/hemolysis, elevated liver enzymes, and low platelet count syndrome; (4) retained stillbirth; (5) septic abortion and intrauterine infection; (6) amniotic fluid embolism; and (7) acute fatty liver of pregnancy. Prompt diagnosis and understanding of the underlying mechanisms of disease leading to this complication in essential for a favorable outcome. In recent years, novel diagnostic scores and treatment modalities along with bedside point-of-care tests were developed and may assist the clinician in the diagnosis and management of DIC. Team work and prompt treatment are essential for the successful management of patients with DIC.

Original languageEnglish
Pages (from-to)452-463
Number of pages12
JournalAmerican Journal of Obstetrics and Gynecology
Volume213
Issue number4
DOIs
StatePublished - 1 Oct 2015
Externally publishedYes

Keywords

  • acute fatty liver of pregnancy
  • endothelial dysfunction
  • hemolysis elevated liver enzymes, and low platelet count (HELLP) syndrome
  • hemorrhage
  • score
  • trophoblast

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