HIV and AIDS in pregnancy, health and medicine homework help

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D.I.C (DISSEMINATED INTRAVASCULAR
COAGULOPATHY)
Specific Learning Objectives








Describe why pregnancy is a hypercoagulable state
Explain the physiology of coagulation cascade mechanism
Describe the pathophysiology of DIC
List conditions associated with DIC
Describe obstetric conditions associated with DIC
Explain complications associated with DIC
Discuss the management of DIC

Def: A condition associated with inappropriate activation of
coagulation & fibrinolytic systems.
Physiology of coagulation cascade mechanism
1

Thrombin
• Proteolytic enzyme
2

• Split fibrinogen chains into fibrinoid peptides
• Fibrinoid peptides form fibrin monomer

NB: Activation of coagulation system also 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 haemostatic mechanism represents a
delicate & complex balance between coagulation & fibrinolytic
systems

PREGNANCY CHANGES
Pregnancy represents a hypercoagulable state
• Overall increase in activity of coagulation factors except XI
& XIII.
• Fibrinogen rises as early as 12/52 with peak 400 –465mg/dl
in late pregnancy
3

• Fibrinolytic system depressed during pregnancy & labour
but back to normal within 1hr after 3rd stage.
• Early puerperium
▪ Secondary rise in fibrinog...


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