The role of blood component therapy in obstetrics (a study of 100 cases with deranged coagulation profile)

This study was carried out to study the incidence of DIC in various obstetric conditions and to study the role of component therapy and its effects on the deranged coagulation profile and maternal outcome in patients with deranged coagulation profile.

An observational retrospective study design was selected for this study. A total of 100 cases that had presented to labour room of our hospital between January 2013 and January 2014 with deranged coagulation profile were studied for improvement in maternal outcome after giving component therapy. All the antenatal women admitted and having alteration in any of the following laboratory parameters were included in the study (Hb, Platelet, PT, INR, aPTT, Sr. fibrinogen). Patients having jaundice due to obstetric condition (excluding any infective etiology like hepatitis or other hepatic conditions) were included. Any patient having just altered hemoglobin suggestive of anemia and transfused with red cell concentrate for the same were excluded. Any patients with medical condition like ITP, SLE, and Dengue etc. that can alter coagulation profile were excluded.

21 patients tested positive for D-dimer i.e. 21 patients had DIC among 100 patients with deranged coagulation profile during study period. Incidence of DIC in our study was 0.002%. Out of patients with DIC, 42.85% had IUFD, 42.85% severe pre-eclampsia, 30.49% abruptio placenta, 19.04% eclampsia and 14.28% had PPH. Incidence of DIC in PPH-60%, abruptio placenta 23.07%, severe pre-eclampsia 23.07%, eclampsia 22.22% and 20.8% in IUFD.