DIC; Incidence, Causes and Maternal Outcome in Basrah Maternity and Children Hospital

Abstract

Thirteen cases of DIC were studied retro and prospectively for the period from 1st June 1999 till 30th June 2000 in Basrah Maternity and Children Hospital, with an age range of 25-42 years and a parity range of 1-7. They were proved clinically by combined supervision of a Physician and an Obstetrician and the assessment of prothrombine time and platelets count. Seven of them eventually died due to uncontrollable bleeding. The remaining six survived the attack. Genital tract injuries (3 cases), placenta accretes (2 cases), amniotic fluid embolism (2 cases), postoperative Caesarian section (2 cases), incompatible blood transfusion (1 case), induced abortion (1 case), pre-eclampsia (1 case) and hydatidiform mole gestation (1 case) were noticed to be the major precipitating factors for the problem. The total number of deliveries during the period of the study was (11235).This gives an incidence rate of 1.15/1000 live births. Eight cases (62%) were of low social class, four cases (40%) of medium social class and only one case (8%) of high social class. The present study also probed the role of different other parameters in DIC like parity, presence/absence of ANC and the availability of fresh blood. The presenting study was also compared to different other studies done on the same subject, which shows that there was only seven cases of Maternal death due to DIC (for the period 1988-1992) in Basrah Maternity and Children Hospital. So we think that our results indicates that the problem of DIC is increasing during recent years, probably due to defective management