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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Many gynaecological units have a policy of performing routine coagulation tests in cases of missed abortion. For many years now, it has been accepted practice in our unit to perform routinely a platelet count, bleeding time (BT), clotting time (CT) and plasma fibrinogen (P. fib) level prior to evacuation in cases of missed abortion. We are not sure how or why these 4 tests came to be chosen as a coagulation 'screen'. As they are not totally adequate in detecting disseminated intravascular coagulation (DIC), we wondered if these tests added to the management in any way.
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PMID:Routine coagulation tests in cases of missed abortion--is it really necessary? 130 81

We present a study of fibrinogen levels in 133 patients who were prone to develop disseminated intravascular coagulation as a result of an underlying complication of pregnancy such as abruptio placentae, pregnancy-induced hypertension, missed abortion, septic abortion, intrauterine fetal death, vesicular mole and amniotic fluid embolism. A high incidence of hypofibrinogenemia was found in cases of abruptio placentae (43.9%) and pregnancy-induced hypertension (25%). Hypofibrinogenemia occurred in 10% cases of intrauterine fetal death within 4 weeks of fetal demise. The use of this simple investigation makes possible the diagnosis of hemostatic failure and also helps to guide replacement therapy during the fibrinopenic state. There were 4 maternal deaths and 12 perinatal losses in this study.
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PMID:Relevance of plasma fibrinogen estimation in obstetric complications. 130 90

Four probable cases of amniotic fluid embolism (AFE) are reviewed. The outcome appeared to be determined by the severity of the insult, and possibly the gestation of the pregnancy, rather than the management of the AFE. Two cases occurred during early labour; neither patient recovered consciousness. One died two weeks later and the other suffered severe permanent cerebral damage. The other two cases occurred during dilatation and curettage, one for therapeutic abortion at fourteen weeks gestation and the other for missed abortion at twenty weeks gestation. Both patients made full recoveries. Disseminated intravascular coagulation (DIC) was a feature of all four cases. In the patients in labour it occurred almost immediately. In those undergoing dilatation and curettage it occurred after the patients had apparently recovered but were under observation in the intensive care unit. Amniotic fluid embolism can occur during an apparently uneventful labour. It should also be suspected when unexplained collapse occurs during second trimester dilatation and curettage. Because severe DIC may follow, such patients should be transferred immediately to a centre with full haemotology services.
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PMID:Amniotic fluid embolism: a report of four probable cases. 371 41

Obstetrician-gynecologists at Assaf Harofeh Medical Center in Zerifin, Israel, performed 1064 midtrimester (14-22 weeks) pregnancy terminations between 1978 and 1993 by the laminaria and evacuation technique. Medical researchers wanted to determine whether the 70 (6.6%) patients with a previous Cesarean section faced an increased perioperative risk. None of the 70 women suffered any major complications (e.g., cervical lacerations). The mean operative time for women with a scarred uterus was not significantly different than that for those with an unscarred uterus (7.44 vs. 8 minutes). When the researchers examined only missed abortion cases, however, the mean operative time for women with a scarred uterus was significantly shorter than that for women with an unscarred uterus (4.8 vs. 6 minutes; p .005). Among missed abortion cases, more laminaria tents were needed in women with a scarred uterus than in those with an unscarred uterus (3.7 vs. 2.91; p .01), suggesting that the number of laminaria tents accounted for the difference in operative time. Among women with an unscarred uterus, 8 missed abortion cases had disseminated intravascular coagulation and 2 women experienced uterine atony with hemorrhage during the induced abortion. Except for those with disseminated intravascular coagulation, all the women were discharged from the hospital on the same day as the procedure. These findings show that laminaria and evacuation is a safe midtrimester pregnancy termination technique and that, since it requires only a few hours in an outpatient postoperative facility, it is also cost effective.
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PMID:Safety of midtrimester pregnancy termination by laminaria and evacuation in patients with previous cesarean section. 805 41

We reported a rare case of acute disseminated intravascular coagulation (DIC) after dilation and curettage in an adenomyosis and missed abortion patient. The clinical performance improved after treatment with tranexamic acid, blood transfusions and subtotal hysterectomy. Hemorrhage, degeneration and necrosis were found in the myometrium. Pregnancy-related thrombotic tendency, accelerated uterus tissue injury after curettage, activation of coagulation system, microthrombosis formation, myometrium necrosis, exhaustion of coagulation factors and hyperfibrinolysis might play the crucial roles in the pathophysiology of acute DIC. Physicians should be alert that adenomyosis patients undergoing dilation and curettage may be in danger of DIC.
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PMID:Acute disseminated intravascular coagulation developed after dilation and curettage in an adenomyosis patient: a case report. 2386 45