Abstract Number: PB0362
Meeting: ISTH 2020 Congress
Background: Disseminated intravascular coagulation (DIC) is one of the commonest causes of abnormal bleeding during pregnancy and puerperium. It’s successful management requires early recognition, specific but vigorous treatment, a challenging feat in resource limited settings (RLS).
Aims: To determine Obstetricians’ approach in diagnosing and treating obstetrics DIC in a RLS.
Methods: A semi-structured pre-tested 4-sectioned questionnairre was used to collect demographic data of Nigerian Obstetricians and data on their practice in the diagnosis and treatment of obstetrics DIC.
Results: A total of 171 Obstetricians responded with a majority of them (67.2%) having 5-15 years of specialist practice. Within the year under review, most of the respondents saw < 10 cases of DIC each. Preeclampsia was the most frequent cause identified (70.2%) followed by postpartum haemorrahge (58.3%). Platelet count determination was the test mostly used (95.9%) to make a diagnosis of DIC whereas, antithrombin assay was the least (20.6%) requested investigation. While about two-third would monitor the evolution of DIC, a little less than half of the Obstetricians would not repeat laboratory testing more than every 2 days, reason mainly (61.8%) due to patient's financial constraint. Likewise, majority will not look out for non-overt DIC. Majority would treat for low haemoglobin concentration and platelet count and a platelet transfusion trigger of 20-50 x109/L was used by 73.2% of the respondents. Almost three-quarter of them preferred fresh whole blood as the first line of treatment of DIC.
There was a non-significant association between years of practice and use of DIC score and index of suspicion for non-overt DIC, However, there was a significant association between years of practice and serial monitoring of evolution of DIC (X2 10.8 p value 0.02).
Conclusions: DIC remains a challenge in the obstetrics practice in RLS especially in investigations, monitoring and index of suspicion for non-overt DIC.
To cite this abstract in AMA style:Okoye H, Nwagha T, Ugwu E, Menuba I, Duru A, Ugwu A, Ezebialu I, Eze S, Ugwu A. Diagnosis and Treatment of Obstetrics Disseminated Intravascular Coagulation in Resource Limited Settings [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/diagnosis-and-treatment-of-obstetrics-disseminated-intravascular-coagulation-in-resource-limited-settings/. Accessed October 1, 2023.
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