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Am J Obstet Gynecol. 2015 Oct;213(4):452-63. doi: 10.1016/j.ajog.2015.03.054. Epub 2015 Mar 31.

Disseminated intravascular coagulation in pregnancy: insights in pathophysiology, diagnosis and management.

Author information

1
Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel. Electronic address: erezof@bgu.ac.il.
2
Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel; Department of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria Policlinico di Bari, Universitá degli Studi di Bari "Aldo Moro", Bari, Italy.
3
Department of Haematology, Manchester Royal Infirmary, Manchester, United Kingdom.

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.

KEYWORDS:

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

PMID:
25840271
DOI:
10.1016/j.ajog.2015.03.054
[Indexed for MEDLINE]

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