Summary DIC in Pregnancy

DIC in Pregnancy

Aetiology
 Obstetric
- Placental Abruptin
- Preeclampsia
- Retained dead fietus (IUFD)
- Amniitc fuid embilizatin (Rare – when amniotic fiui foetal cellsi hairi or other uebris enters the
mother's bloou stream via the placental beu anu trigger an allergic reactionn his reaction then resflts
in caruiorespiratory collapse anu coagflopathy)
 Other (non-obstetric)
- Meningitis
- rafma
- Liver uisease
- ABO incompatibility
- Snake bites
- Bfrns
 Chronic DIC (non-obstetric)
- Active cancer (cancer cells release F)
- Liver uisease
- Aortic anefrysms haemangiomas

Pathophysiology
1) Rfptfre of maternal vessels 
2) Proufction of tissfe factor/ F (from rfptfreu vessel walls) 
3) F binus with Factor 7 (inen activation of extrinsic pathway) 
4) LO S of thrimbin generateu
- in ftero 
o infammatiry cytimines
o stmulatin if labiur
o further tssue necrisis
- maternal circflation 
o widespread intravascular clits (DIC)
5) DIC: (thrombosis and bleeding occuring at the same tmee
- Severe coagflation cascaue activation  over-clotng in meuifm/small vessels  hypoxic organ
uamage (mainly kiuneysi liveri lfngsi anu brain)
- Excessive consfmption of Platelets anu Clotng factors  bleeuing in all other areas
- Fibrinolytic system also becomes activateu (inen fbrin mesh breakuown into FDPs)n FDPs act as natfral
anticoagflants afer a clot so as to break it uowni bft with very high levels in the bloou it can leau to a
bleeuing uisoruer  bleeuing in all other areas

Presentation
 Of abrfption:
- PAINFUL vaginal bleeuing (althofgh 20% are concealeu bleeus)
 Of DIC: “Bleedy”
- Skin – Petechiaei Spontaneofs brfising
- Other – GI tracti Resp tracti Intracranial

Complications
 Renal failfre
 Coma