Disseminated intravascular coagulopathy in pregnancy: thorough comprehension of etiology and management reduces obstetricians' stress

In pregnancy and puerperium disseminated intravascular coagulopathy may acc ompany abruptio placenta, intrauterine fetal demise with retained dead fetu s, amniotic fluid embolism, endotoxin sepsis, preecalampsia with HELLP and massive transfusion. Clinical signs and symptoms of DIC can include oozing from venupuncture sites and/or mucous membranes, red cell lysis from activa tion of the complement system, hemorrhage from coagulopathy and possible ut erine atony, hypotension from hemorrhage and/or bradykinin release, and oli guria from end-organ insult and hypovolemia/hypotension. Treatment of DIC c onsists of replacement of volume, blood products, and coagulation component s and cardiovascular and respiratory support with elimination of underlying triggering mechanism.