Obstetrik hastalarda dissemine intravasküler koagulasyon: maternal ve fetal sonuçları

Abstract

AIM: In our study, it was aimed to obtain guiding information to prevent complications that may develop in advance and to decrease maternal and fetal morbidity and mortality by evaluating the antepartum of patients who developed DIC due to obstetric reasons. 
 MATERIALS AND METHODS: Obstetric patients who were hospitalized in obstetrics and perinatology clinics and developed disseminated intravascular coagulation (DIC) were retrospectively analyzed. DIC scoring of the patients was made according to the International Society on Thrombosis and Haemostasis (ISTH) criteria. Maternal and fetal outcomes from the patients were documented.
 RESULTS: During the 6-year period in which the data were analyzed, DIC was detected in 57 pregnants out of 108281 deliveries, and the incidence of DIC was found to be 0.052%. The categories of pregnancy complication preceding DIC: placental invasion and implantation anomalies, postpartum hemorrhage (atonia), placental abruption, hypertensive disease of pregnancy and others were found. Its rate in maternal morbidity was 38.6% and maternal mortality rate was 1.75% with 1 patient. 35% of the patients had laparotomy / re-laparotomy and 21% of these patients had hysterectomy. The average birth weight of the newborn is 2341.3 grams. Neonatal intensive care need is 34.5%, stillbirth rate is 25.5%. Neonatal mortality rate was determined as 3.6%. 
 CONCLUSION: The management scheme plays a key role in delivery because termination of pregnancy often eliminates the underlying obstetric disorder. Early diagnosis and active treatment protocols reduce mortality and morbidity. Because of the physiological changes seen in the coagulation cascade during pregnancy, using a pregnancy-specific DIC score instead of the ISTH DIC score developed for non-pregnant adults may facilitate diagnosis.