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1 - Disseminated intravascular coagulation in obstetrics, pregnancy, and gynecology: Criteria for diagnosis and management

Published online by Cambridge University Press:  01 February 2010

By
Rodger L. Bick M.D., Ph.D., F.A.C.P.  and
Deborah Hoppensteadt Ph.D., D.I.C.
Edited by
Rodger L. Bick ,
Eugene P. Frenkel ,
William F. Baker  and
Ravi Sarode
Rodger L. Bick M.D., Ph.D., F.A.C.P.
Affiliation:
Clinical Professor of Medicine and Pathology, University of Texas Southwestern Medical Center, Director: Dallas Thrombosis Hemostasis and Vascular Medicine Clinical Center, Dallas, Texas, USA
Deborah Hoppensteadt Ph.D., D.I.C.
Affiliation:
Associate Professor of Pathology, Loyola University Medical Center, Maywood, Illinois, USA
Rodger L. Bick
Affiliation:
University of Texas Southwestern Medical Center, Dallas
Eugene P. Frenkel
Affiliation:
University of Texas Southwestern Medical Center, Dallas
William F. Baker
Affiliation:
University of California, Los Angeles
Ravi Sarode
Affiliation:
University of Texas Southwestern Medical Center, Dallas
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Summary

Syndromes of disseminated intravascular coagulation in obstetrics, pregnancy and gynecology Objective criteria for diagnosis and management

Introduction

Disseminated intravascular coagulation is a confusing syndrome, regarding diagnostic and therapeutic modalities. Confusion and controversy stem from (1) the fact that many unrelated clinical scenario may induce DIC (2) a lack of uniformity in clinical manifestations (3) confusion regarding appropriate laboratory diagnosis and (4) unclear guidelines for management with respect to specific therapeutic modalities potentially available. Recommendations for and evaluation of management becomes even more difficult because: (1) the morbidity and survival is often dependent on the specific cause of DIC and (2) few of the generally used specific modes of therapy, heparin, antithrombin concentrate, protein C concentrate, and others, have been subjected to objective prospective randomized trials, except antithrombin concentrates.

This chapter provides specific and objective guidelines and criteria for (1) the clinical diagnosis, (2) laboratory diagnosis, and (3) to provide objective systems to assess efficacy of any given specific therapeutic modality, independent of influences of the underlying (inducing) disease causing the DIC in obstetrical, pregnancy or gynecological patients. This approach allows for objective decisions regarding diagnosis and management in particular obstetric and gynecological settings and in individual patients. A general review of the etiology, pathophysiology, clinical and laboratory diagnosis, and management modalities suggested for DIC in obstetrics and gynecology is provided.

Disseminated intravascular coagulation (DIC) is an intermediary mechanism of disease usually seen in association with well-defined clinical disorders.

Type
Chapter
Information
Hematological Complications in Obstetrics, Pregnancy, and Gynecology , pp. 1 - 54
Publisher: Cambridge University Press
Print publication year: 2006

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