Cited by 177Pregnancy and preeclampsia studiesBlood Coagulation and Thrombosis MechanismsTrauma, Hemostasis, Coagulopathy, Resuscitation

Disseminated intravascular coagulation in obstetric disorders and its acute haematological management

Thachil, Jecko, Toh, Cheng-Hock·2009·Blood Reviews

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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Crossref · 10.1016/j.blre.2009.04.002

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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).”

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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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