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DIC obstetric

Offer Erez
During a women's life cycle, pregnancy is a period in which she is at risk for hemorrhagic events and obstetrical syndromes that may develop into disseminated intravascular coagulation (DIC). This life-threatening condition is a complication of obstetrical and non-obstetrical causes including: (1) acute peripartum hemorrhage (uterine atony, cervical and vaginal lacerations, and uterine rupture); (2) placental abruption; (3) Pre-eclampsia/HELLP syndrome; (4) retained stillbirth; (5) sepsis; (6) amniotic fluid embolism; and (7) acute fatty liver of pregnancy...
March 2017: Thrombosis Research
Soichiro Obata, Michi Kasai, Junko Kasai, Kazuo Seki, Zenjiro Sekikawa, Izumi Torimoto, Shigeo Takebayashi, Fumiki Hirahara, Shigeru Aoki
Although it is widely accepted that uterine artery embolization (UAE) is an effective therapeutic strategy for postpartum hemorrhage (PPH), no consensus has been reached regarding the efficacy of UAE in patients with PPH with disseminated intravascular coagulation (DIC). This single-center retrospective cohort study included patients treated with UAE using NBCA for PPH between 2010 and 2015. The patients were divided into DIC and non-DIC groups, according to the obstetrical DIC score and the overt DIC diagnostic criteria issued by the International Society of Thrombosis and Haemostasis (ISTH), and their clinical outcomes were compared...
2017: BioMed Research International
Naoaki Tamura, Mustari Farhana, Tomoaki Oda, Hiroaki Itoh, Naohiro Kanayama
Amniotic fluid embolism (AFE) is recognized as a type of syndrome characterized by the abrupt onset of hypoxia, hypotension, seizures, or disseminated intravascular coagulopathy (DIC), occurring during labor, delivery, or immediately postpartum, caused by the inflow of amniotic components into the maternal circulation. AFE is a rare condition but one of the most serious obstetrical complications, resulting in a high mortality rate among pregnant women. Despite earlier recognition and intensive critical management, we often encounter patients who unfortunately do not recover from the exacerbation of AFE-related conditions...
February 11, 2017: Journal of Obstetrics and Gynaecology Research
Snehalata C Gupte, Abhay G Jhaveri
To understand transfusion requirement in DIC with respect to (wrt) underlying cause. Patients' details were analyzed using parameters like yearly requirement, hemoglobin (Hb) and blood components utilization wrt age, sex and cause of DIC. Total 1931 DIC cases from 167 hospitals received 21,153 blood units including whole blood, red cell concentrate fresh frozen plasma, random donor platelets, single donor platelets and cryoprecipitate from year 2001 to 2013. Significant risk of DIC was for females compared to males (p < 0...
June 2016: Indian Journal of Hematology & Blood Transfusion
Anupama Dave, Laxmi Maru, Astha Jain
OBJECTIVE: The aim of the study was to find out the role of Serum lactate dehydrogenase in prediction of adverse outcomes of PE & E i.e., severity of disease and occurrence of complications. MATERIALS AND METHODS: This study was conducted in the Department of Obstetrics and Gynaecology, MGM Medical College, Indore. A total of 200 women were studied; they were divided into control (n = 100), severe pre-eclampsia (n = 32), eclampsia (n = 68). Demographic and hematological parameters were studied including LDH levels...
February 2016: Journal of Obstetrics and Gynaecology of India
Mikkel Allingstrup, Jørn Wetterslev, Frederikke B Ravn, Ann Merete Møller, Arash Afshari
BACKGROUND: Critical illness is associated with uncontrolled inflammation and vascular damage which can result in multiple organ failure and death. Antithrombin III (AT III) is an anticoagulant with anti-inflammatory properties but the efficacy and any harmful effects of AT III supplementation in critically ill patients are unknown. This review was published in 2008 and updated in 2015. OBJECTIVES: To examine:1. The effect of AT III on mortality in critically ill participants...
February 8, 2016: Cochrane Database of Systematic Reviews
Houchang Modanlou, Shandee Hutson, Allan Thurman Merritt
A male infant delivered to a primipara woman following vacuum applications. He was vigorous at birth, with small caput and scalp bruising. His head was enlarging; he became pale with respiratory distress. Subgaleal hemorrhage (SGH) was suspected. His hematocrit was noted to be 26.2 percent prior to transfusion of O, Rh-negative blood (40 mL/kg). Moderate disseminated intravascular coagulation (DIC) was noted at 12 hours of age. Posttransfusion of fresh frozen plasma (FFP), his condition became stable, and DIC gradually resolved...
2016: Neonatal Network: NN
Annahita Sarcon, Xiaoli Liu, David Ton, James Haywood, Todd Hitchcock
Background. Disseminated intravascular coagulopathy (DIC) is a complication of an underlying disease and not a primary illness. It is most commonly associated with sepsis, trauma, obstetrical complications, and malignancies. There are very few cases in the literature illustrating the association between DIC and congestive heart failure. Findings. In this report, we present a case of severe congestive heart failure, leading to biventricular thrombi and subsequently DIC. Conclusion. We suggest that the association between congestive heart failure and DIC is an underrecognized one...
October 2015: Journal of Investigative Medicine High Impact Case Reports
Chikako Oi, Yasuo Hori, Hiroaki Sano, Yoshihiro Yamama, Keiji Nakatani
Amniotic fluid embolism (AFE) is a disorder with a high mortality rate. We present a case of AFE with cardiac arrest during the cesarean section who recovered sequela. A 28-year-old woman was diagnosed as low lying placenta and planned to undergo cesarean section in 38th gestational week. She had atypical genital bleeding in 32nd gestational weeks and she received emergency cesarean section under general anesthesia. After expulsion of her fetus, she lost many blood. We suspected obstetric DIC and started therapy immediately, but cardiac arrest occurred suddenly...
November 2015: Masui. the Japanese Journal of Anesthesiology
L O Buzyan
BACKGROUND: Iron deficiency anemia is traditionally considered to be a pathological condition during pregnancy. According to the standards, prescription of iron supplements to pregnant women is required at hemoglobin levels of 110 g/l and lower. Numerous studies at different periods showed the relationship of anemia and premature birth [5], preeclampsia [1], low birth-weight [2]. Meanwhile, physiological hemodilution carries in pregnancy an important adaptive function. It is well known, that in the second half of pregnancy physiological hypercoagulability develops (increased activity of the plasma clotting factors, platelet aggregation, decreased activity and blood concentrations of physiological anticoagulants) aimed at implementing adequate hemostasis in labor...
2015: International Journal of Risk & Safety in Medicine
S Pantovic, S Kadija, J Dotlic, J Stojnic, K Jeremic, R Sparic, A Stefanovic
A primigravid woman at 29th gestational week with placental abruption causing fetal death, that underwent instant cesarean section, developed a disseminated intravascular coagulation (DIC), revealed by hemoperitoneum and hematoma of the abdominal wall. After re-laparotomy and transfusion of blood, fresh plasma, and platelets, the patient was discharged from hospital on the 14th postoperative day completely recovered. To conclude, conservative surgical approach for DIC treatment is possible and safe. Novel antifibrinolitic drugs are recommended for obstetrical patients with DIC to enable a healthy subsequent pregnancy...
2015: Clinical and Experimental Obstetrics & Gynecology
Serdar Başaranoğlu, Mehmet Sıddık Evsen, Elif Ağaçayak, Senem Yaman Tunç, Zülfikar Yılmaz, Yaşar Yıldırım, Avşeqüi Deregözü, Muhammet Erdal Sak, Zeynep Baysal Yıldırım, Gönül Ölmez Kavak, Talip Gül
OBJECTIVE: The purpose of the present study is twofold: (a) to investigate the etiology of disseminated intravascular coagulopathy (DIC) caused by obstetrical conditions and (b) to present parameters that can be used in predicting DIC-related mortality in obstetrical patients. MATERIAL AND METHOD: Obstetrical patients who had a delivery at or were referred (after delivery) to Obstetrics and Gynecology Clinic of Dicle University between July 2006 and December 2013 were retrospectively analyzed in this study...
September 2016: Journal of Maternal-fetal & Neonatal Medicine
Masato Yoshihara, Kaname Uno, Sho Tano, Michinori Mayama, Mayu Ukai, Shinya Kondo, Tetsuya Kokabu, Yasuyuki Kishigami, Hidenori Oguchi
INTRODUCTION: Recombinant human soluble thrombomodulin (rhTM) is a novel anti-coagulant agent that regulates the imbalanced coagulation system by reducing the excessive activation of thrombin. rhTM potentially reduces the morbidity and mortality in patients with sepsis-induced disseminated intravascular coagulation (DIC). However, the efficacy of rhTM in obstetric DIC has not yet been established. We performed this study to examine whether the administration of rhTM was a potentially effective treatment for DIC induced by one or more underlying obstetric disorders...
2015: Critical Care: the Official Journal of the Critical Care Forum
M del-Rio-Vellosillo, J J Garcia-Medina
BACKGROUND: HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) is an obstetric complication with heterogonous presentation and multisystemic involvement. It is characterized by microangiopathic hemolytic anemia, elevated liver enzymes by intravascular breakdown of fibrin in hepatic sinusoids and reduction of platelet circulation by its increased consumption. METHODS: In terms of these patients' anesthetic management, it is essential to consider some details: (1) effective, safe perioperative management by a multidisciplinary approach, and quick, good communication among clinical specialists to achieve correct patient management; (2) neuroaxial block, particularly spinal anesthesia, is the first choice to do the cesarean if there is only moderate, but not progressive thrombocytopenia; (3) if a general anesthesia is required, it is necessary to control the response to stress produced by intubation, especially in patients with either severe high blood pressure or neurological signs, or to prevent major cerebral complications; (4) invasive techniques, e...
February 2016: Acta Anaesthesiologica Scandinavica
F Gary Cunningham, David B Nelson
Disseminated intravascular coagulation (DIC) is a syndrome that can be initiated by a myriad of medical, surgical, and obstetric disorders. Also known as consumptive coagulopathy, DIC is a common contributor to maternal morbidity and mortality and is associated with up to 25% of maternal deaths. The etiopathogenesis of DIC is complex and currently thought to be initiated by tissue factor or thromboplastin, which is released from trophoblastic or fetal tissue, or maternal decidua or endothelium. Tissue factor activates the coagulation sequence to cause fibrin clotting and its dissolution by the fibrinolysin system...
November 2015: Obstetrics and Gynecology
Robert Rydze, Kamilah Dixon, Jocelyn T Greely, Shannon M Hawkins
BACKGROUND: Postabortion hemorrhage occurs in up to 2% of second-trimester pregnancy terminations. Postabortion hemorrhage is the leading cause of postabortion maternal mortality. We report the successful use of an obstetric balloon for second-trimester postabortion hemorrhage complicated by disseminated intravascular coagulation. CASE: A 38-year-old multigravid woman presented with hypovolemic shock from disseminated intravascular coagulation after second-trimester termination of an anomalous fetus...
November 2015: Obstetrics and Gynecology
Alberto Rebonato, Stefano Mosca, Matthias Fischer, Sandro Gerli, Gianluigi Orgera, Luigina Graziosi, Daniele Maiettini, Gian Carlo Di Renzo, Giorgio Epicoco, Miltiadis Krokidis, Michele Rossi, Michele Scialpi
OBJECTIVES: To retrospectively evaluate safety and efficacy of pelvic artery embolisation (PAE) in post-partum haemorrhage (PPH) in abnormal placental implantation (API) deliveries. METHODS: From January 2009 to November 2013, 12 patients with API and intractable intraoperative PPH underwent PAE after caesarean delivery to control a haemorrhage (in four of these cases after hysterectomy). Arterial access was obtained prior to the delivery; PAE was performed in the obstetrics operating room by an interventional radiologist that was present with an interventional radiology (IR) team during the delivery...
June 2016: European Radiology
Rimantas Benetis, Ruta Nadisauskiene, Edmundas Sirvinskas, Tadas Lenkutis, Adakrius Siudikas, Vytaute Kadusauskaitė, Dalia Railaitė, Arturas Sukovas, Vytautas Abraitis
We report a unique clinical case about an 18-year-old woman, immediately post-partum after an urgent C-section, who survived severe sepsis, acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC) and was successfully treated with 11 different antibiotics, massive blood transfusions and repetitive surgeries and was on extracorporeal membrane oxygenation (ECMO) support for 22 days. Although, ECMO is a time-limited procedure and most manufacturers do not advise more than 14 days of use, the situation for this patient was life-threatening and ECMO, despite the dangerous risks listed above, was the only way to win time for the lungs to recover and for treatment of the underlying disease, while maintaining adequate oxygenation and circulation...
May 2016: Perfusion
Jaya Chawla, D Arora, Mohini Paul, Sangita N Ajmani
OBJECTIVES: We sought to determine the frequency, demographic characteristics, indications, and feto-maternal outcomes associated with emergency peripartum hysterectomy in an easily accessible urban center. METHODS: We conducted a retrospective, observational, and analytical study over a period of eight years, from August 2006 to July 2014. A total of 56 cases of emergency obstetric hysterectomy (EOH) were studied in the Department of Obstetrics and Gynecology, Kasturba Hospital, New Delhi...
May 2015: Oman Medical Journal
Shintaro Makino, Satoru Takeda, Takao Kobayashi, Maki Murakami, Takahiko Kubo, Toshiyuki Hata, Hideaki Masuzaki
AIM: The aim of this study was to provide basic documents applicable to studying the usefulness of administering fibrinogen concentrate to patients with massive post-partum hemorrhage. We investigated the usage of fibrinogen concentrate at training institutions for specialist physicians of the Japan Society of Obstetrics and Gynecology. MATERIAL AND METHODS: The subjects were women who required fibrinogen concentrate for hemostasis of post-partum hemorrhage during the period between April 2008 and March 2013...
August 2015: Journal of Obstetrics and Gynaecology Research
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