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Indian Journal of Obstetrics and Gynecology Research


Diagnosis and treatment of coagulopathy secondary to single fetal demise in twin pregnancy


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Author Details: Jennia Michaeli*,Ella Kitroser,Alexander Ioscovich,Arnon Samueloff,Hen Y. Sela

Volume : 5

Issue : 4

Online ISSN : 2394-2754

Print ISSN : 2394-2746

Article First Page : 573

Article End Page : 575



Abstract

Introduction: Disseminated intravascular coagulation following single fetal demise in a twin pregnancy is a rare event. As such, the diagnosis and management of such cases are complicated and require the assistance of various laboratory tests.
Case: 26 years old patient, carrying dichorionic diamniotic twin pregnancy was complicated by single fetal demise at 21+6 weeks and preterm premature rupture of membranes (PPROM) at 24+5 weeks. Pregnancy was managed conservatively until 30+4 weeks gestation when abnormal laboratory tests including dysfibrinogenemia and pathological thromboelastogram (TEG) indicated the development of disseminated intravascular coagulopathy (DIC) while the patient remained asymptomatic. A multidisciplinary team decided on prompt delivery by cesarean section. Cesarean delivery (CD) was uneventful, yet post-operative course was complicated by worsening laboratory tests and post-partum hemorrhage that were treated by uterotonics and blood products resulting in clinical and laboratory normalization.
Conclusion: DIC following single fetal demise in a twin pregnancy is rare. A new laboratory test, TEG, may aid in diagnosis and management of DIC.

Keywords: Twins, Disseminated intravascular coagulation (DIC), Intrauterine fetal demise (IUFD), Thromboelastogram (TEG), Coagulopathy.

Doi :-https://doi.org/10.18231/2394-2754.2018.0129