Disseminated intravascular coagulation in the HELLP syndrome: how much do we really know?

Kjell Haram, Jan Helge Mortensen, Salvatore Andrea Mastrolia, Offer Erez

Research output: Contribution to journalReview articlepeer-review

38 Scopus citations

Abstract

The rate of disseminated intravascular coagulation (DIC) during pregnancy varies among nations from 0.03% to 0.35%. The existing reports suggest dissimilarity in the underlying mechanisms leading to DIC during gestation. While in developing countries preeclampsia and the HELLP syndrome are prevalent causes of DIC, the leading causes in the developed countries are placental abruption and postpartum hemorrhage. In different cohort studies, DIC is reported in about 12–14% of women with preeclampsia. Nevertheless, it has been suggested that in most cases these women also had a HELLP syndrome and that the occurrence of DIC in women who had only preeclampsia without manifestations of the HELLP syndrome is rare. The aims of this review are to: (1) highlight the mechanisms leading to DIC; (2) describe the changes in the coagulation system during this complication; and; (3) discuss the diagnostic tool and treatment modalities of DIC, in women who develop a HELLP syndrome.

Original languageEnglish
Pages (from-to)779-788
Number of pages10
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume30
Issue number7
DOIs
StatePublished - 3 Apr 2017

Keywords

  • DIC
  • fibrinolysis
  • placental abruption
  • systemic inflammation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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