RT Book, Section A1 Samuels, Philip A2 Foley, Michael R. A2 Strong, Jr, Thomas H. A2 Garite, Thomas J. SR Print(0) ID 1152536218 T1 Disseminated Intravascular Coagulopathy and Thrombocytopenia Complicating Pregnancy T2 Obstetric Intensive Care Manual, 5e YR 1 FD 1 PB McGraw-Hill Education PP New York, NY SN 9781259861758 LK obgyn.mhmedical.com/content.aspx?aid=1152536218 RD 2024/03/29 AB Although uncommon, significant hemorrhage, coagulopathy, and need for transfusion are encountered by every practicing obstetrician. We often walk a fine “tight rope” trying to determine when to deliver a patient or when to wait longer. With our increasing emphasis on preventing prematurity, we are being more conservative in treating preeclampsia and patients with third trimester bleeding. The possible trade-off more abruption and HELLP (hemolysis, elevated liver enzyme levels, and low platelet levels) syndrome; hence more disseminated intravascular coagulopathy (DIC). Prevention is obviously superior to treatment. By understanding the pathophysiology and events that lead to these potentially catastrophic clinical situations, we can respond more rapidly and often prevent them from progressing to critical situations. Even with meticulous care, we cannot prevent all such cases. Rapid, decisive, and knowledgeable action on the part of the obstetrician can usually avert an adverse outcome. In this chapter, I cover the areas of clinical DIC and clinically significant thrombocytopenia. The best form of therapy is aimed at correcting the underlying pathophysiologic problem, as well as treating the acquired or inherent clotting problem. There are many ways to treat these clinical entities. This chapter outlines a practical approach to these patients with these complications.