Disseminated intravascular coagulation in obstetric disorders and its acute haematological management
Abstract
As activation of the coagulation pathway is a physiological response to injury, the development of disseminated intravascular coagulation (DIC) is a warning signal to the clinician that the primary pathological disease state is decompensating. In pregnancy, DIC can occur in several settings, which include emergencies such as placental abruption and amniotic fluid embolism as well as complications such as pre-eclampsia. Whilst the acuteness of the event and the proportionality in the coagulant and fibrinolytic responses may vary between these different conditions, a common theme for pregnancy-associated DIC is the pivotal role played by the placenta. Removal of the placenta is the linchpin to treatment in most cases but appropriate blood product support is also key to management. This is necessary because DIC itself can have pathological consequences that translate clinically into a worse prognosis for affected patients. This article will describe how pregnancy-associated DIC can be diagnosed promptly and how treatment should be managed strategically. It also discusses the latest developments in our understanding of haemostatic mechanisms within the placenta and how these may have relevance to new diagnostic approaches as well as novel therapeutic modalities.
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When significant amounts of thrombin become intravascular, consumptive coagulopathy or disseminated intravascular coagulation may ensue with potential for maternal morbidity and mortality.
“When significant amounts of thrombin become intravascular, consumptive coagulopathy, or disseminated intravascular coagulation (DIC), may ensue with potential for maternal morbidity and mortality (21).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [21]
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- Authors
- Thachil, J., & Toh, C.-H.
- Affiliations
- University of Liverpool (GB)
- Corresponding author
- Thachil, Jecko
- Venue
- Blood Reviews
- Publisher
- Elsevier BV
- Published
- 2009-07
- Volume
- 23
- Issue
- 4
- Pages
- 167-176
- ISSN
- 0268-960X (ISSN-L)
- OpenAlex
- W2112900314
- Cited by
- 177
- References
- 118
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 10 · 2023: 10 · 2022: 15 · 2021: 8 · 2020: 11 · 2019: 7 · 2018: 11 · 2017: 11 · 2016: 11 · 2015: 9 · 2014: 10 · 2013: 16 · 2012: 18
- FWCI
- 1.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Blood Reviews (publishedVersion)
- PubMed (publishedVersion)
- Funders
- British Heart Foundation
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
- Keywords
- disseminated intravascular coagulation, placental abruption, amniotic fluid embolism, preeclampsia, placenta, hemostasis, fibrinolysis, placental removal
- MeSH terms
- Anticoagulants, Blood Coagulation Factors, Disseminated Intravascular Coagulation, Female, Postpartum Hemorrhage, Humans, Obstetric Labor Complications, Placenta, Pregnancy, Pregnancy Complications, Hematologic, Thromboplastin, Factor VIIa, Blood Component Transfusion
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