Kobayashi listed obstetrical conditions that may be associated with disseminated intravascular coagulation (DIC). Identifying the underlying cause can help guide management. The author is from Hamamatsu Medical Center in Shizuoka, Japan.
Patient selection: pregnant woman with DIC
Obstetrical conditions that may precipitate DIC:
(1) placental abruption
(2) amniotic fluid embolism
(3) eclampsia and preeclampsia
(4) HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count)
(5) massive post-partum hemorrhage
(6) sepsis or other severe infection
(7) dead fetus syndrome
(8) acute fatty liver of pregnancy
(9) severe shock
where:
• Trauma may precede several of the listed conditions.
• Post-partum hemorrhage may be secondary to DIC. Massive transfusion may be associated with a dilutional coagulopathy.
• Severe vasculitis may trigger a consumptive coagulopathy but may present as eclampsia.
• Venomous snake bite might be a cause in some parts of the world.
