DISSEMINATED INTRAVASCULAR COAGULATION IN OBSTETRIC PATIENTS AT COMBINE MILITARY HOSPITAL QUETTA
Disseminated Intravascular Coagulation
Objective: To describe the frequency of disseminated intravascular coagulation (DIC) as a complication in obstetric patients.
Study Design: Descriptive studyPlace and Duration of Study: This study was carried out between April 2006 to August 2007 at the department of obstetrics and gynecology, Combined Military Hospital Quetta.Subjects and Methods: All pregnant subjects who presented at the out-patient department, CMH Quetta for delivery or related complaints were considered for inclusion into the study. After various exclusions, a total of 1939 patients were included in our study. They were consented, and evaluated with detailed history and clinical examination for the presence of DIC. In suspected patients DIC screening was ones’s, including fibrinogen levels, prothrombin time, partial thromboplastin time, platelet and fibrin degradation products. These patients were regularly followed up during the course of the disease till their discharge or otherwise.
Results: Out of 1939 subjects 15 (0.77%) subjects developed disseminated intravascular coagulation. Out of these 15 subjects, 10 (66.7%) subjects were having no booking record. 10 (66.7%) subjects developing DIC were multi-gravida, while 5 (33.3%) were primary gravida. The major complications leading to DIC in our subjects were abruption 4 (26.7%), intrauterine death 4 (26.7%) and sepsis 4 (26.7%).13 (86.7%) ladies were finally discharged without complications, while 1 (6.7%) subject developed acute renal failure and 1 (6.7%) subjects died.
Conclusion: Disseminated intravascular coagulation is a grave complication of obstetrical population, which increases the maternal mortality and morbidity.