Disseminated Intravascular Coagulation in Obstetric and Gynecologic Disorders

Martina Montagnana; Massimo Franchi; Elisa Danese; Francesca Gotsch; Gian Cesare Guidi

doi:10.1055/s-0030-1254049

Seminars in Thrombosis and Hemostasis, Table of Contents

Semin Thromb Hemost 2010; 36(4): 404-418
DOI: 10.1055/s-0030-1254049

Disseminated Intravascular Coagulation in Obstetric and Gynecologic Disorders

Martina Montagnana¹ , Massimo Franchi¹ ^, ² , Elisa Danese¹ ^, ² , Francesca Gotsch¹ ^, ² , Gian Cesare Guidi¹ ^, ²

¹Sezione di Chimica Clinica, Dipartimento di Scienze Morfologico-Biomediche, Università degli Studi di Verona, Verona, Italy
²Unità di Ostetricia, Dipartimento Materno ed Infantile, Università degli Studi di Verona, Verona, Italy

Abstract

ABSTRACT

Disseminated intravascular coagulation (DIC) is a syndrome characterized by a massive, widespread, and ongoing activation of the coagulation system, secondary to a variety of clinical conditions. Many obstetric complications, such as abruptio placentae, amniotic fluid embolism, endotoxin sepsis, retained dead fetus, post-hemorrhagic shock, hydatidiform mole, and gynecologic malignancies, might trigger DIC. In these gynecologic and obstetric settings, DIC is usually associated with high mortality and morbidity rates. No single laboratory test is sensitive or specific enough to diagnose DIC definitively, but it can be diagnosed by using a combination of multiple clinical and laboratory tests that reflect the pathophysiology of the syndrome. At present, the therapeutical approach to pregnancy- and gynecologic-related DIC comprises the specific and aggressive treatment of the underlying disease, eventually followed by a supportive blood product replacement therapy and restoration of physiological anticoagulant pathways. This article reviews the etiopathogenesis, clinical manifestations, laboratory diagnosis, and therapy of pregnancy- and gynecologic-related DIC.

KEYWORDS

Coagulation - disseminated intravascular coagulation - DIC - obstetrics - pregnancy

Full Text

References

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Dr. Martina MontagnanaM.D.

Sezione di Chimica Clinica Università degli Studi di Verona, Ospedale Policlinico G.B. Rossi

P.le Scuro 10, 37134 – Verona, Italy

Email: martina.montagnana@med.lu.se