[Disseminated intravascular coagulation. Retrospective study of 14 acute obstetrical cases].
To test the value of diagnostic and therapeutic data in obstetric DIC, 14 women were selected who presented a severe clotless haemorrhage with fibrin degradation products and/or soluble complexes, decreased fibrinogen (0.87 +/- 0.47 g X 1(-1)), platelet count (75.7 +/- 41 X 10(3) X ml-1) and prothrombin complex (33.7 +/- 12%). The hypovolaemia was treated at the same time as heparin was given in a bolus injection of 0.5 mg X kg-1 followed by a constant flow infusion of 1 mg X kg-1 X day-1 in all patients. Relevant obstetrical treatment was performed in 71.4% of patients. Fibrinogen, fresh frozen plasma, prothrombin complex concentrate and platelet concentrate were given if required. One patient, with severe toxaemia, died. Haemorrhage was stopped in 92.8% of patients after 4.5 +/- 0.8 h. Reversible visceral complications occurred in 28% of cases. The initial data used was easily obtained and seemed to give a reliable diagnosis in acute obstetrical DIC. Substitutive treatment was discussed in correlation with the evolution: PCC seemed pointless; the use of fibrinogen must become exceptional when fresh frozen plasma is available. Heparin remained necessary.
D000208:Acute Disease; D000328:Adult; D001780:Blood Coagulation Tests; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D010949:Plasma; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy*; D012189:Retrospective Studies; D014592:Uterine Hemorrhage / Q000209:etiology / Q000628:therapy
D006493:Heparin
Coagulation intravasculaire disséminée. Etude rétrospective de 14 cas obstétricaux aigus.