title: Successful treatment of two patients with postpartum disseminated intravascular coagulation complicated by abdominal compartment syndrome.
abstract: Disseminated intravascular coagulation (DIC) and abdominal compartment syndrome (ACS) are rare complications of pregnancy, and even more rare are cases with both complications occurring concomitantly. Obstetricians are relatively unfamiliar with these types of cases, the majority of which are fatal. We describe here a primigravida with acute fatty liver of pregnancy and a multipara with placental abruption who each developed uterine inertia complicated by postpartum DIC that required total hysterectomy. They developed ACS postoperatively and required decompressive laparotomy to alleviate increased intra-abdominal pressure and end-organ dysfunction. After timely decompressive laparotomy, both patients recovered without any additional complications and were discharged within 4 weeks of their initial admission. These 2 cases serve to remind obstetricians to consider the possibility of ACS whenever there is a fresh wound in the abdominal cavity of a patient with postpartum DIC. However, even when there is severe deterioration in the condition of a patient with ACS, immediate decompressive laparotomy may not be appropriate; the timing of the procedure is very important.
authors.affiliation: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang City, Liaoning Province, PR China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Na
authors.forename: Cai-xia
authors.initials: CX
authors.lastname: Liu
authors.forename: Hong
authors.initials: H
authors.lastname: Cui
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Si-shi
authors.initials: SS
authors.lastname: Liu
authors.forename: Qiu-ling
authors.initials: QL
authors.lastname: Li
mesh_terms: D000037:Abruptio Placentae; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D019299:Decompression, Surgical; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005234:Fatty Liver / Q000150:complications; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects; D059325:Intra-Abdominal Hypertension / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D011225:Pre-Eclampsia; D011247:Pregnancy; D011248:Pregnancy Complications; D011644:Puerperal Disorders / Q000209:etiology / Q000601:surgery; D014593:Uterine Inertia / Q000209:etiology / Q000601:surgery