What is disseminated intravascular coagulopathy and how is it managed?
DIC is characterized by activation of systemic coagula-tion leading to consumption of clotting factors and activation of secondary fibrinolysis. This will result in hypofibrinogenemia, thrombocytopenia, and the produc-tion of fibrin degradation products. The clinical presentation is marked by hemorrhage, lack of clot formation, and bleeding from all puncture sites, such as intravenous insertion sites. Abnormal laboratory values include elevation in prothrombin time (PT), partial thromboplastin time (PTT), low platelet count, and fibrinogen level (Table 61.3).
Successful treatment of DIC requires removal of the source, i.e., delivery of the fetus and placenta. In addition to delivery, treatment of the coagulopathy with fresh frozen plasma, cryoprecipitate, for fibrinogen replacement, and platelets will be necessary until the process begins to reverse.