Disseminated Intravascular Coagulation in Abruptio Placenta: Who is at Risk?

Creative Commons License

Tuğcu D., Uygur L., Oya D.

Journal of Clinical Obstetrics and Gynecology, cilt.34, sa.2, ss.60-66, 2024 (ESCI, Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 34 Sayı: 2
  • Basım Tarihi: 2024
  • Doi Numarası: 10.5336/jcog.2023-101168
  • Dergi Adı: Journal of Clinical Obstetrics and Gynecology
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.60-66
  • Anahtar Kelimeler: Abruptio placenta, disseminated intravascular coagulation, uteroplacental insufficiency, out-patient follow-up
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

This study aimed to determine the clinical risk factors of disseminated intravascular coagulation (DIC) in case of an abruptio placenta. The second objective was to evaluate the maternal and perinatal complications in the cases with DIC secondary to abruptio placenta. Material and Methods: This is a retrospective study conducted in pregnant women with a diagnosis of abruption at a tertiary maternity hospital. 237 patients confirmed with abruptio placenta were assigned into two groups: complicated with DIC (study group), and those who were not (control group). Results: 23 patients were included in the study group, and 214 patients were included in the control group. In the study group, 82.6% of the patients were admitted urgently from the emergency room with diagnosis of abruption, whereas the rate of the patients diagnosed in the emergency room was 49.1% in the control group (p=0.002). The rate of cases with a ≥50% detachment of the total placental mass was significantly higher in the DIC group (91.3% vs. 41.7%). Uterine atony, Couvelaire uterus, transfusion of blood products, intensive care unit admission were significantly higher in the DIC group. Intrauterine fetal demise, neonatal excess base deficit, neonatal intensive care unit admission were also significantly higher in the DIC group. Conclusion: The patients presenting with vaginal bleeding, fetal demise, those who have ≥50% of the placenta detached, and those who are diagnosed in emergency department have higher likelihood of being complicated with DIC. The patients with known risk factors for abruption and their neonates benefit from in-patient follow-up.