Ann. Pak. Inst. Med. Sci. 2012; 8(3): 200-204

Objective: To determine the frequency of disseminated intravascular coagulation in high risk obstetric patients, using scoring system of international society of thrombosis and hemostasis (ISTH).
Place and Duration: The study was conducted in the Maternal and Child Health Center (Outpatient and Inpatient Department), Pakistan Institute of Medical Sciences, Islamabad. from August 2010 to August 2011.
Study Design: Descriptive case series.
Materials and Methods: It was a descriptive case series conducted at Maternal and Child Health Centre,PIMS Islamabad. A total of 97 high risk pregnancies(pre-eclampsia,eclampsia,placental abruption,PPH,in utero fetal death) presented in emergency were recruited and their ISTH score was calculated. Two groups were made, group I with ISTH score<5 and group II with ISTH score>5 and both groups were followed for the out-come in term of development of DIC and maternal mortality associated with DIC.
Results: Out of 97 patients 25 (25.7%) in high risk obstetric patients, using scoring system of international society of thrombosis and hemostasis (ISTH)..%) patients developed disseminated intravascular coagulation on the basis of clinical findings of uterine or generalized bleeding from multiple sites. DIC remained more prevalent amongst primigravidae i-e 45%. The major predisposing cause was found to be PPH i-e 64%. The proportion of patients with DIC who had ISTH score less than 5 were significantly lesser (15% vs. 72%, P-value < 0.05) as compared with patients having ISTH score equal or more than 5. There were 5 maternal deaths, one in group I and 4 (80%) deaths in the group II. The comparison of DIC showed significant association between ISTH score and DIC.
Conclusion: Disseminated intravascular coagulation is a grave complication in obstetri-cal population,
PPH is the major predisposition followed by placental abruption and pre eclampsia. ISTH score equal or more than 5 in high risk obstetric patients has significant association with DIC and mortality associated with it.
Key Words: Disseminated intravascular coagulation, ISTH score, DIC, High risk pregnan-cies.

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