Disseminated intravascular coagulation in abruptio placentae (Dissertation). Karachi: Coll Physicians Surg Pak;

ABSTRACT Objectives: To assess the proportion of Disseminated Intravascular Coagulation (DIC) in abruptio placentae and outcome of such patients with DIC. Methodology: This Descriptive study was conducted in the Department of Obstetrics and Gynecology (OBG) ward 8, unit -1 at Jinnah post Graduate Medical Centre (JPMC) Karachi from 1 st January, 2001 to 31 December 2002. This study was carried out on 100 diagnosed cases of abruptio placentae; and its adverse effects were noted on haemostatic system. Patients who came through the Emergency Department of (OBG) or Main Emergency of JPMC with a history of ante partum hemorrhage was included in this study. Written consent was taken from patients for using information regarding history, clinical Examination and related investigations for the research purpose. Results: DIC was found in seven out of 100 patients, they were relatively younger and Multiparous. Mean age was 27.5 years while parity ranged between Para 5-11 with mean gestational age of 33.14 weeks. Six (85.7%) patients had severe vaginal bleeding, abdominal pain and uterine tenderness. Coagulation profile and routine laboratory investigations revealed that all patients had raised fibrin degradation products, clotting, and prothrombin and activated thromboplastin time, while decreased serum fibrinogen, platelets and hemoglobin. All cases were immediately managed with fluid replacement and blood transfusion. Six (85.7%) cases were delivered by spontaneous vaginal delivery and only one (14.3%) case by caesarean section. Fetal mortality was high 6 (85.7%) all were fresh still birth while only one (14.3%) baby was alive. There was no maternal death. Conclusions: The proportion of DIC in abruptio placentae was found to be 7%. Early diagnosis and immediate treatment of abruptio placentae are important factors for successful therapy of DIC. Fetal mortality was directly proportional to amount of blood loss, initial level of maternal hemoglobin and gestational age. No maternal death occurred