Diagnosis and treatment of coagulopathy secondary to single fetal demise in twin pregnancy
Journal Title: Indian Journal of Obstetrics and Gynecology Research - Year 2018, Vol 5, Issue 4
Abstract
Introduction Disseminated intravascular coagulation following single fetal demise in a twin pregnancy is a rare event As such the diagnosis and management of such cases are complicated and require the assistance of various laboratory testsCase 26 years old patient carrying dichorionic diamniotic twin pregnancy was complicated by single fetal demise at 216 weeks and preterm premature rupture of membranes PPROM at 245 weeks Pregnancy was managed conservatively until 304 weeks gestation when abnormal laboratory tests including dysfibrinogenemia and pathological thromboelastogram TEG indicated the development of disseminated intravascular coagulopathy DIC while the patient remained asymptomatic A multidisciplinary team decided on prompt delivery by cesarean section Cesarean delivery CD was uneventful yet postoperative course was complicated by worsening laboratory tests and postpartum hemorrhage that were treated by uterotonics and blood products resulting in clinical and laboratory normalizationConclusion DIC following single fetal demise in a twin pregnancy is rare A new laboratory test TEG may aid in diagnosis and management of DICKeywords Twins Disseminated intravascular coagulation DIC Intrauterine fetal demise IUFD Thromboelastogram TEG Coagulopathy
Authors and Affiliations
Jennia Michaeli, Ella Kitroser, Alexander Ioscovich, Arnon Samueloff, Hen Y. Sela
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