The causes of this pathology, mainly, lie in the problems that arise during pregnancy and childbirth. To develop the syndrome DVS can and in the postpartum period, both the mother and the newborn.
Diagnosis and treatment of the ICE syndrome is very difficult. According to statistics, the mortality from this pathology in its acute form is 30%. It is important to remember that due to vigilance of doctors and professional diagnostics it is possible to stop the disease at the first stage of its development or to significantly reduce the risk of the pathology transition in the following phases.
What is the ICE syndrome?
Disseminated intravascular coagulation, DIC-syndrome? this is a violation of hemostasis (the inability of the body to cope with bleeding), which is characterized by blood clotting with the formation of microclots and aggregates of blood cells that block blood circulation. Due to such changes, deep degenerative changes in the organs develop, which are accompanied by a decrease in the blood's ability to coagulate (hypocoagulation), a decrease in the number of platelets in a unit of blood volume (thrombocytopenia) and bleeding (hemorrhage).
The severity and speed of the development of DIC syndrome are very diverse. There are several forms of its development: lightening (for an hour), acute (for several hours), subacute (for several days), chronic (for months and years), relapsing (the condition periodically exacerbated with intervals of remission), latent (latent).
DIC-syndrome during pregnancy, as a rule, has a chronic or acute form. The chronic form of the DIC syndrome occurs as a result of extragenital pathology in pregnant women (cardiovascular diseases, glomerulonephritis, blood disease and other diseases), acute form? as a result of significant hemorrhage (hypotonic bleeding, embolism with amniotic fluid).
Causes of DIC-syndrome in pregnant women
DIC-syndrome in pregnant women often arises as a complication of infectious and inflammatory processes. Among the main causes of the development of pathology are the following:
- Embolism with amniotic fluid? develops during complicated births and is characterized by the entry of amniotic fluid into the bloodstream, which can occur after a rupture of the uterus or its neck, caesarean section, pathological development of the membranes. The onset of amniotic fluid in the bloodstream is promoted by placenta previa, premature detachment of the normally located placenta, increased hydrostatic pressure in the uterine cavity.
- Premature abruption of the placenta? detachment of the normally located placenta before the birth of the child. In most cases, it is accompanied by bleeding from the genital tract. After detachment, the placenta can sometimes form a hematoma.
- Gestosis? severe late toxemia of pregnancy, which, as a rule, develops in the third trimester. Characterized by the appearance of protein in the urine, edema, high blood pressure and leads to a violation of uteroplacental blood circulation.
- Hemorrhagic shock? very strong stress of the body, which can occur due to hemorrhages.
- Sepsis? a generalized purulent infection of the blood, which can be triggered by intrauterine fetal death, septic abortion and inflammation of membranes, transfusion of incompatible blood.
- Endometritis? inflammation of the inner lining of the uterus, which develops after childbirth and can be complicated by the lightning-fast form of the DIC syndrome.
DIC-syndrome can also occur in pregnant women who have cardiovascular, kidney, liver, rhesus-conflict, etc.
Stages of development of DIC syndrome< h3> Hypercoagulation (increased blood coagulability)
Lasts from several minutes (acute DVS-syndrome) to several days (chronic DVS-syndrome). Without laboratory diagnosis this stage can be latent. External signs: increased blood filling (hyperemia) of the skin and their cyanotic color (cyanosis), often a marble pattern on the upper and lower extremities, sometimes chills, tachycardia.
Hypocoagulation (reduced blood clotting) without active dissolution of blood clots and blood clots
External signs: increased bleeding from the birth canal or area of ??the operating wound, nosebleeds, hemorrhages on the skin, lateral surfaces of the thorax, hips, upper eyelid. Blood from the uterus contains loose clots that quickly break down. < Hypocoagulation with active dissolution of blood clots and blood clots. External signs: liquid non-clotting blood is secreted, sometimes single small clots are formed that quickly break down, bleeding from the uterus or the area of ??the operating wound occurs, and also from injection sites, blood appears in the urine, hemorrhages in the thoracic and abdominal cavities, pericardium.
Complete blood coagulation (afibrinogenemia)
The duration of clinical manifestations is 7-9 hours or more.
Prevention and treatment of DIC-syndrome in pregnant women
All pregnant women need to conduct a study of hemostasis in order to identify any disorders. The first signal for concern may be the results of a pregnant woman's blood test for hemostasis.
A study of the blood coagulation system is called a coagulogram. This analysis allows to reveal the peculiarities of clotting disorder in a pregnant woman and some complications of pregnancy. It is advisable to take a coagulogram once in a trimester, and in the presence of deviations in hemostatic parameters, according to the doctor's prescription, even more often.
Blood for analysis is taken from the vein in the morning on an empty stomach. Diagnosis of the severity of hemostasis disorders will help timely treatment.
Treatment of DIC-syndrome in pregnancy
Treatment of DIC-syndrome is prescribed by a hematologist in accordance with the peculiarities of the stage of development of the disease. In effective treatment, it is important not only the recommendations of a doctor, but also the assistance of a midwife.
The main keys to successful treatment are the elimination of pathological processes in the body and the elimination of the shock state of the patient. Pathological processes exacerbate the development of DIC syndrome; therefore, for the initiation of therapy, laboratory diagnostics of all phases of the DIC syndrome, establishing its connection with inflammatory and infectious processes, and surgical interventions is of great importance.
Help to stop the further development of DIC-syndrome or significantly alleviate its complications can eliminate the shock that arose.
To combat these phenomena, the physician prescribes complex transfusion therapy, which consists in the intravenous administration of various medicaments in the form of solutions for the purpose of correcting homeostatic disorders.