Abstract
Disseminated intravascular coagulation (DIC) in the postpartum period is a rare but
potentially life-threatening complication arising from various obstetric conditions,
including postpartum hemorrhage (PPH), placental abruption, intrauterine fetal demise
(IUFD), and amniotic fluid embolism. This review explores pathophysiology, risk factors,
diagnostic challenges, and management strategies of postpartum DIC. The delicate balance
of hemostasis during pregnancy predisposes women to thromboembolic events, which,
when disrupted, may lead to rapid consumption of coagulation factors and subsequent
coagulopathy. The incidence of obstetric-related DIC varies globally, with higher
rates reported in low-resource settings due to delayed diagnosis and management. Diagnostic
criteria, including the International Society on Thrombosis and Haemostasis (ISTH),
Japanese obstetric DIC, and pregnancy-specific DIC scores, are evaluated, emphasizing
their applicability and limitations in obstetric practice. Preventive strategies,
primarily targeting the early identification and treatment of PPH, are discussed,
with particular focus on active management of the third stage of labor, the administration
of uterotonic agents, and the use of antifibrinolytic medications like tranexamic
acid. Timely recognition, standardized diagnostic protocols, and multidisciplinary
management are essential for improving maternal outcomes and reducing the burden of
postpartum DIC.
Keywords
postpartum period - disseminated intravascular coagulation (DIC) - postpartum hemorrhage
(PPH)
