Abstract
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 · 1 −1). platelet count (75.7 ± 41 · 10 3 · 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 · kg −1 followed by a constant flow infusion of 1 mg · kg −1 · 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.
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