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Semin Thromb Hemost 2010; 36(4): 404-418
DOI: 10.1055/s-0030-1254049
© Thieme Medical Publishers

Disseminated Intravascular Coagulation in Obstetric and Gynecologic Disorders

Martina Montagnana1 , Massimo Franchi1 , 2 , Elisa Danese1 , 2 , Francesca Gotsch1 , 2 , Gian Cesare Guidi1 , 2
  • 1Sezione di Chimica Clinica, Dipartimento di Scienze Morfologico-Biomediche, Università degli Studi di Verona, Verona, Italy
  • 2Unità di Ostetricia, Dipartimento Materno ed Infantile, Università degli Studi di Verona, Verona, Italy
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Publication History

Publication Date:
07 July 2010 (online)

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ABSTRACT

Disseminated intravascular coagulation (DIC) is a syndrome characterized by a massive, widespread, and ongoing activation of the coagulation system, secondary to a variety of clinical conditions. Many obstetric complications, such as abruptio placentae, amniotic fluid embolism, endotoxin sepsis, retained dead fetus, post-hemorrhagic shock, hydatidiform mole, and gynecologic malignancies, might trigger DIC. In these gynecologic and obstetric settings, DIC is usually associated with high mortality and morbidity rates. No single laboratory test is sensitive or specific enough to diagnose DIC definitively, but it can be diagnosed by using a combination of multiple clinical and laboratory tests that reflect the pathophysiology of the syndrome. At present, the therapeutical approach to pregnancy- and gynecologic-related DIC comprises the specific and aggressive treatment of the underlying disease, eventually followed by a supportive blood product replacement therapy and restoration of physiological anticoagulant pathways. This article reviews the etiopathogenesis, clinical manifestations, laboratory diagnosis, and therapy of pregnancy- and gynecologic-related DIC.

KEYWORDS

Coagulation - disseminated intravascular coagulation - DIC - obstetrics - pregnancy

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Dr. Martina MontagnanaM.D. 

Sezione di Chimica Clinica Università degli Studi di Verona, Ospedale Policlinico G.B. Rossi

P.le Scuro 10, 37134 – Verona, Italy

Email: martina.montagnana@med.lu.se