2M.S. Obstetrics and Gynecology, Civil Hospital, Ahmedabad
BACKGROUND:Objectives: Disseminated intravascular coagulation (DIC) is characterized by systemic activation of blood coagulation, which results in generation and deposition of fibrin, leading to microvascular thrombi in various organs and contributing to multiple organ dysfunction syndromes (MODS); at the same time bleeding from other sites due to consumption of coagulation factors. In this study we aim to find out common obstetric conditions leading to DIC. We also study the average DIC score, range of DIC scores and mortalityobserved in these obstetric conditions. Design: A retrospective study of hospital records was done on 70 random cases of DIC defined by elevated laboratory parameters like platelet count, FDP, S. fibrinogen and PT timefrom July-2011 to October-2013 at Civil Hospital, Ahmedabad. The patients were divided in two groups: Overt DIC (DIC score ≥ 5) and non-overt DIC (DIC score < 5). RESULTS: Mean age of patients was 24.31 years; range being 20-36 years. Mean gravida was 2.43 ranging from 1-7.Major causes of DIC were abruption (53%) and HELLP (34%). There were 32 patients (46%) of overt DIC and 38 patients of non overt DIC.Overall mortality rate was 27% (19/70) and overt DIC mortality rate was 59% (19/32).None of the patients with non-overt DIC died.Most common cause of overt DIC was HELLP(13/32, 41%) followed by Abruption(11/32, 34%). CONCLUSION: Overt DIC brings high rate of mortality. Care should be taken in case of patients with HELLP and abruption to avoid overt DIC and thereby reduce the mortality rate.