Podcast
Questions and Answers
What is the primary cause of disseminated intravascular coagulation (DIC) during pregnancy?
What is the primary cause of disseminated intravascular coagulation (DIC) during pregnancy?
Which of the following is NOT a known predisposing factor for DIC during pregnancy?
Which of the following is NOT a known predisposing factor for DIC during pregnancy?
Which event is NOT included in the process of haemostasis?
Which event is NOT included in the process of haemostasis?
What is the incidence range of DIC as indicated in the content?
What is the incidence range of DIC as indicated in the content?
Signup and view all the answers
How does DIC typically resolve?
How does DIC typically resolve?
Signup and view all the answers
What triggers the vasoconstriction after a blood vessel injury?
What triggers the vasoconstriction after a blood vessel injury?
Signup and view all the answers
What happens during platelet plug formation?
What happens during platelet plug formation?
Signup and view all the answers
What is the role of thrombin in blood coagulation?
What is the role of thrombin in blood coagulation?
Signup and view all the answers
Which clinical finding is indicative of DIC?
Which clinical finding is indicative of DIC?
Signup and view all the answers
What is a common clinical sign of obstetric DIC?
What is a common clinical sign of obstetric DIC?
Signup and view all the answers
What is essential for the successful management of women with DIC?
What is essential for the successful management of women with DIC?
Signup and view all the answers
Which of the following is a basic principle in treating obstetrical DIC?
Which of the following is a basic principle in treating obstetrical DIC?
Signup and view all the answers
Which of the following is NOT a component of supportive treatment in cases of DIC?
Which of the following is NOT a component of supportive treatment in cases of DIC?
Signup and view all the answers
What factors should be discussed by the multidisciplinary team when considering delivery options?
What factors should be discussed by the multidisciplinary team when considering delivery options?
Signup and view all the answers
What laboratory finding can confirm thrombocytopenia in a patient suspected of DIC?
What laboratory finding can confirm thrombocytopenia in a patient suspected of DIC?
Signup and view all the answers
What complication can occur due to late diagnosis of DIC?
What complication can occur due to late diagnosis of DIC?
Signup and view all the answers
In the management of DIC, why is rigorous clinical and laboratory surveillance important?
In the management of DIC, why is rigorous clinical and laboratory surveillance important?
Signup and view all the answers
What should be considered when small healthcare facilities evaluate their capability to manage massive blood transfusions?
What should be considered when small healthcare facilities evaluate their capability to manage massive blood transfusions?
Signup and view all the answers
Which medical specialists should be promptly involved in the care of a patient with DIC?
Which medical specialists should be promptly involved in the care of a patient with DIC?
Signup and view all the answers
What is a potential consequence of untreated DIC?
What is a potential consequence of untreated DIC?
Signup and view all the answers
Which of the following treatments is specifically used to address coagulopathy in DIC?
Which of the following treatments is specifically used to address coagulopathy in DIC?
Signup and view all the answers
Study Notes
Disseminated Intravascular Coagulation (DIC)
- DIC is a unique entity during pregnancy, secondary to an underlying disease or complication.
- It subsides when the underlying condition resolves.
- Incidence is 0.03%-0.35%.
- DIC can result from pregnancy complications or unrelated issues like sepsis or trauma.
Predisposing Factors
- Acute peripartum hemorrhage (uterine atony, cervical/vaginal lacerations, uterine rupture)
- Placental abruption
- Pre-eclampsia/eclampsia/HELLP syndrome
- IUD/Retained stillbirth
- Septic abortion & intrauterine infection
- Amniotic fluid embolism
- Acute fatty liver of pregnancy
Haemostasis
- Normal blood flow occurs freely in a blood vessel.
- When a vessel wall is damaged, a reaction occurs to prevent blood loss.
- This reaction involves three events:
- Vascular spasm: Vasoconstriction resulting from vessel injury, blood compression, and chemical release (pain receptors stimulate platelets).
- Platelet plug formation: Platelets aggregate at exposed areas of the vessel wall. Platelets release thromboxane A2 and other chemicals to promote vascular spasm and attract more platelets.
- Coagulation of blood: Prothrombin activator is formed, converting prothrombin to thrombin. Thrombin causes fibrinogen to form fibrin threads, trapping red/white blood cells and stopping bleeding.
DIC Pathophysiology
- In DIC, procoagulation substances are released in excess leading to:
- Excess coagulation (widespread clotting)
- Disruption of blood flow, ischemia, and multi-organ failure
- Consumption and depletion of platelets
- Severe bleeding
Clinical Signs
- Obstetric DIC often presents more with bleeding than clotting complications.
Diagnosis
- Diagnosis is usually based on clinical assessment of the patient (review of history, clinical situation).
- Early diagnosis is essential to prevent multi-organ failure and uncontrolled hemorrhage, which have high mortality rates.
Clinical Findings
- DIC can be asymptomatic.
- Haemorrhage severity depends on the extent of the process.
Laboratory Investigations
- Full examination of clinical condition.
- Lab tests confirm:
- Thrombocytopenia (low platelet count) - identifies increased destruction
- Prolonged prothrombin time (PT)
- Partial thromboplastin time (PTT)
- Low fibrinogen level
- Rising D-dimer
Treatment
- Treatment focuses on resolving the underlying condition, especially before the threshold of viability, through fast and prompt delivery or termination.
- Delivery options discussed among a multi-disciplinary team.
- Supportive treatment with blood products (plasma, red blood cells, platelets, fibrinogen) and surgical care as needed.
- Continuous clinical and lab surveillance.
- For small health facilities, consider possible referral to larger facilities for blood bank support and massive blood transfusion when appropriate.
Summary
- DIC is a life-threatening condition arising from varied obstetric and non-obstetric causes.
- Prompt diagnosis and understanding the underlying mechanisms are crucial for favourable outcomes.
- Teamwork and rapid treatment are essential for successful management.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz covers the essential aspects of Disseminated Intravascular Coagulation (DIC) during pregnancy, including its causes, predisposing factors, and the mechanism of hemostasis. Understanding DIC is crucial for managing pregnancy complications effectively. Test your knowledge on this critical topic.
