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

Several parameters of hemostasis have been studied in 19 patients suffering from abruptio placentae. In 10 of them severe hemostatic alterations were detected and in 5, disseminated intravascular coagulation was observed. The patients were divided into four groups according to the severity of their clinical picture. The degree of placental separation was related to the severity and course of the clinical history and to the alterations in hemostasis detected at the most critical clinical moment. The analytical parameters were evaluated after extraction of the thromboplastic material. A good correlation was observed between the severity of the clinical picture and the degree of placental separation and the greatest analytical alteration, especially with cross-linked soluble fibrin monomer complexes (SFMC). In 9 of the 19 patients who showed analytical and/or clinical alterations, an improvement was detected in these alterations after evacuation of the uterus.
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PMID:Abruptio placentae and disseminated intravascular coagulation. 397 75

Two cases of abruptio placentae with disseminated intravascular coagulation (DIC) were treated with heparin, and coagulation was monitored by thromboelastography as well as the usual hematology tests. The cases demonstrated the vagaries of DIC and both showed decreased overt hemorrhage after heparin treatment was started. Heparin may be indicated for the management of abruptio placentae where delivery is not imminent, where significant disseminated intravascular coagulation exists, and when adequate serial coagulation studies are available.
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PMID:Heparin treatment in abruptio placentae. 482 41

A study was conducted on 40 patients with abruptio placentae complicated by intrauterine death of the fetus, consumption coagulopathy and uterine inertia. All patients had severe hyperfibrinolysis (FDP > 300 microgram/ml). Following correction of shock, amniotomy was performed, intrauterine pressure catheters were placed, and oxytocin infusions were begun in all cases. The diagnosis of uterine inertia was made when the cervix failed to dilate following six hours of this treatment. After diagnosing uterine inertia, 18 patients (group B) did not. All but one patient in group A showed a marked improvement in the associated consumption coagulopathy and a rapid reawakening of uterine activity with progress to spontaneous vaginal delivery. Thirteen patients in group B did not show prepartum improvement in consumption coagulopathy or a resumption of uterine activity. These patients required cesarean section. There were two maternal deaths in group B; the overall complication rate in this group was greater than in group A.
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PMID:Trasylol in the management of abruptio placentae with consumption coagulopathy and uterine inertia. 615 72

Rupture of the uterus is an uncommon obstetric emergency that usually occurs after 36 weeks gestation in a woman with a previous cesarean section. Complete rupture of the uterus with extrusion of the fetus into the peritoneal cavity is associated with high fetal mortality and with hypovolemic shock in the mother. Incomplete ruptures are less catastrophic and are often found incidentally at routine elective cesarean section. Management of uterine rupture consists of prompt recognition, rapid replacement of maternal blood volume, and early laparotomy and hysterectomy or, in selected cases, uterine repair. Disseminated intravascular coagulation has been reported in association with such obstetrical emergencies as abruptio placentae, intrauterine fetal demise, septic abortion, and amniotic fluid embolism. We report a case in which there was clinical and laboratory evidence of DIC in a patient with uterine rupture. The patient was successfully managed with prompt hysterectomy and replacement of coagulation factors.
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PMID:Rupture of the uterus with DIC. 682 98

Abruptio placentae is a rather frequent syndrome in overseas countries. Leading to foetus death most of the time, it often endangers prognosis for the mother's life. Serious complications may be found such as shock due to hypovolaemia, coagulopathy among which process of disseminated intravascular coagulation prevail, organic renal insufficiency that may become unrecoverable because of the cortical atrophy of the kidney. The treatment combines obstetrical means with medical ones. Spontaneous uterine voiding will be tried for, since caesarian operation, often unavoidable, is not free from complication. Rehydration will be carried out by transfusing fresh blood and unfrozen plasma, the amount of which often enormous has to be dealt out in accordance with the central venous pressure.
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PMID:[Retroplacental hematoma overseas]. 685 27

Abruptio placentae tends to be accompanied by abnormal coagulation and fibrinolysis, and is known as high risk pregnancy allowing both mother and fetal lives to endanger. Blood coagulation and fibrinolytic system in abruptio placentae, in particular, sequential changes around its onset have been remained unclarified despite the progress in hematology. This permits an irregular therapeutical process for its acute clinical manifestation. In this study, observation was made of the changes of coagulation and fibrinolytic system mainly in relation to delivery, and hemorrhagic diathesis in abruptio placentae was studied. The results obtained are as follows. The studied patients were 14 cases classified into 8 multipara, 10 toxemia of pregnancy, 6 cesarean section, 11 intrauterine fetal death, and 8 complicated disseminated intravascular coagulation respectively. A moderate type demonstrating an increased serum FDP with retarded ESR and lowering in fibrinogen level were observed, but those abnormalities recovered to normal by 3 days after delivery. In serious case, observations also were made of marked decrease of fibrinogen, prolonged PT and PTT, high concentrations of serum and urinary FDP, lowering in levels of coagulation factors, attenuated platelet counts, retarded ESR, and inhibition of platelet aggregation along with thrombelastgram that showed thrombocytopenic type. All of those anomalies tended to be improved following delivery.
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PMID:[Alterations in coagulation and fibrinolytic system in abruptio placentae (author's transl)]. 706 57

We report a case of splenic rupture after cesarean delivery for abruptio placentae. The diagnosis was not suspected until a laparotomy was performed. Diagnosis and management were complicated by disseminated intravascular coagulation and renal failure. The importance of early diagnosis and management modalities are discussed.
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PMID:Post-cesarean section splenic rupture. 763 90

Retinal detachment is a rare complication of preeclampsia, eclampsia and abruptio placentae. We report a case of bilateral retinal detachment in association with severe preeclampsia complicated with abruptio placentae, intrauterine fetal death and disseminated intravascular coagulation. In obstetric complications, placental thromboplastin may release into maternal circulation and activate the extrinsic coagulation system with resultant disseminated intravascular coagulation. This may be responsible for choroidal ischemia and consequent serous retinal detachment.
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PMID:Retinal detachment in association with preeclampsia and abruptio placentae. 763 40

The etiology and pathogenesis of the HELLP syndrome, a multisystem disease occurring only in pregnancy, are still unclear. Curiously, very few authors have investigated whether inherited factors may be involved. We report two cases of HELLP syndrome in two unrelated women whose fetuses were relatives (first cousins). The first case concerned a woman aged 32 with a normal course pregnancy who was admitted to the hospital for fever, nausea and vomiting, low platelets, hemolysis and increased liver enzymes. Abruptio placentae with fetal death and severe disseminated intravascular coagulation with hemorrhages ensued within a few hours. Hysterectomy was then performed. After treatment with transfusions and drugs the patient slowly improved; 28 days later she left the hospital in good condition. The second case involved a woman aged 31 with a normal course pregnancy who was admitted to the hospital for epigastric pain, nausea, low platelets, hemolysis and increased liver enzymes. The patient underwent an immediate cesarean section and delivered a live infant; no bleeding occurred during or after delivery. The patient's condition rapidly improved and she left the hospital after 13 days. Until now, no author has proved that inherited fetal factors are at work in the HELLP syndrome. Our observations suggest a role for genetic factors, and this needs to be investigated in prospective studies.
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PMID:Is the HELLP syndrome due to inherited factors? Report of two cases. 806 66

Fifty patients with severe pre-eclampsia who presented before 32 weeks' gestation were managed conservatively (sedation, bed rest, antihypertensive therapy and intensive fetal and maternal monitoring) until intervention was indicated. Twelve patients presented before 26 weeks of pregnancy and there were no fetal survivors in this group; 23 presented between 26 and 29 weeks and 8(34,8%) of the babies in this group survived. The rate of perinatal loss in those presenting between 30 and 32 weeks was 26,6% (N = 4). Patients who had a history of a hypertensive disorder in their previous pregnancy(ies) had a higher perinatal mortality rate; 23 such mothers experienced 16 perinatal losses compared with 27 mothers who had no such history and who had only 8 perinatal losses. There was 1 maternal death, there were 2 cases of eclampsia, 3 of pulmonary oedema, 4 of abruptio placentae and 1 case of renal failure; 2 patients had disseminated intravascular coagulation. The local indigent and underprivileged black population have a more aggressive form of early onset of severe pre-eclampsia than that reported for other population groups. The high maternal complication rate of 30,8% and the low fetal survival rate before 26 weeks indicate that there is no place in our setting for expectant management of severe pre-eclampsia in patients presenting before 26 weeks. This applies particularly to those with a previous history of hypertension in pregnancy.
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PMID:Expectant management of early onset of severe pre-eclampsia in Durban. 821 21


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