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

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Case Report

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

Volume : 5, Issue : 4, Year : 2018

Article Page : 573-575

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

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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.

How to cite : Michaeli J, Kitroser E, Ioscovich A, Samueloff A, Sela H Y, Diagnosis and treatment of coagulopathy secondary to single fetal demise in twin pregnancy. Indian J Obstet Gynecol Res 2018;5(4):573-575

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