DIC Flashcards
1
Q
Define DIC..
A
When the proteins which control blood clotting become overactive
2
Q
What are the incidences of DIC?
A
1:1000 pregnancies
3
Q
What are the predisposing factors?
A
Pre-existing conditions trauma sepsis placental abruption major haemorrhage pre-eclampsia/ eclampsia IUD amniotic embolism Ruptured uterus HEELP
4
Q
How would you recognise DIC?
A
Bleeding from GI tract, nose, GU tract, IV sites, wounds, blood not clotting
5
Q
What is the management antenatally?
A
Early identification and screening consultant care Avoid FBS, instrumental deliveries, epis avoid prolonged labour monitor platelets Bloods -Xmatch 2units Alert for APH and PPH in labour
6
Q
What is the intrapartum management?
A
if HB< 9g/dl inform reg Xmatch 2 units Active managment of third stage Prompt repair of trauma cord bloods for fetal VWF prompt VK neonate- oral inform haematologist, consultant obstetrician, consultant anaesthetist Repeat and check coagulation observe wound sites for signs of bleeding remove cannulars promptly
7
Q
Risk factors
A
Renal failure Liver failure jaundice cyanosis convulsion coma brain damage death
8
Q
What is the postnatal management?
A
22% risk off PPH 25% risk of secondary PPH Vigilant postnatal obs (MEOWS) Daily check neonate - bleeding cord, bruising, intracranial bleed neonatal blood screening care with heel prick
