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D.I.C (Disseminated Intravascular Coagulopathy)
Specific Learning Objectives



Understand pregnancy as a hypercoagulable state



Understand the pathophysiology of DIC



List obstetric conditions associated with DIC



Describe clinical features associated with DIC



List complications associated with DIC



Describe the management of DIC

Pathophysiology of DIC
Def: A condition associated with inappropriate activation of
coagulation & fibrinolytic systems.
1

Physiology of coagulation cascade mechanism

XII- Hageman factor, a serine protease
XI –Plasma thromboplastin, antecedent serine protease
IX – Christmas factor, a serine protease
VII – Stable factor, serine protease
VIII – Fibrin stabilizing factor, a transglutaminase
IV (PL) – Platelet membrane phospholipid
Ca++- Calcium ions
TF –Tissue factor

2

Physiology of coagulation cascade mechanism
Thrombin – Proteolytic enzyme:
• Splits fibrinogen chains into fibrinoid peptides leading
• Formation of fibrin monomer
NB: Activation of coagulation system:
• Stimulates conversion of plasminogen into plasmin as
• Protective mechanism against intravascular thrombosis

Plasmin
• Inactivates factors V & VIII

• Lyses fibrin & fibrinogen to form degradation products
Thus, normal physiologic haemostasis represents a delicate & complex
balance between coagulation & fibrinolytic systems

Pregnancy Changes
Pregnancy represents a hypercoagulable state
• Overall increased activity of coagulation factors except XI & XII...


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