Evaluation of obstetrical patients with disseminated intravascular coagulopathy - tertiary center experience

J Matern Fetal Neonatal Med. 2016 Sep;29(18):2929-33. doi: 10.3109/14767058.2015.1108403. Epub 2015 Nov 23.

Abstract

Objective: The purpose of the present study is twofold: (a) to investigate the etiology of disseminated intravascular coagulopathy (DIC) caused by obstetrical conditions and (b) to present parameters that can be used in predicting DIC-related mortality in obstetrical patients.

Material and method: Obstetrical patients who had a delivery at or were referred (after delivery) to Obstetrics and Gynecology Clinic of Dicle University between July 2006 and December 2013 were retrospectively analyzed in this study. Those patients diagnosed with DIC were included in the study.

Results: Fifty-six obstetrical patients carrying the diagnosis of DIC were included in this study. The overall mortality rate was 25% among these patients. More specifically, the mortality rate was 10.7% among patients with a DIC score ≤5 and 40.7% among those with a DIC score > 5. Multiple logistic regression analysis resulted in the finding that international normalized ratio (INR) and urea were among those factors affecting mortality in obstetrical DIC [OR: 8.44 (CI: 1.9-36.8), OR: 1.05 (CI: 1.0-1.1), respectively].

Conclusion: DIC is a syndrome that might be caused by obstetrical conditions. It is associated with high mortality and morbidity rates. In obstetrical DIC, urea is the most important factor affecting mortality. In addition, we are of the opinion that DIC score might guide mortality predictions as a determinant of prognosis.

Keywords: Diagnosis; disseminated intravascular coagulopathy; obstetrical bleeding; relaparotomy; treatment.

MeSH terms

  • Adult
  • Delivery, Obstetric / methods
  • Disseminated Intravascular Coagulation / classification
  • Disseminated Intravascular Coagulation / etiology*
  • Disseminated Intravascular Coagulation / mortality*
  • Female
  • Humans
  • Incidence
  • International Normalized Ratio
  • Logistic Models
  • Maternal Mortality
  • Postpartum Period / blood
  • Pregnancy
  • Pregnancy Complications, Hematologic / classification
  • Pregnancy Complications, Hematologic / etiology*
  • Pregnancy Complications, Hematologic / mortality*
  • Retrospective Studies
  • Risk Factors
  • Tertiary Care Centers
  • Urea

Substances

  • Urea