Disseminated Intravascular Coagulation Associated with Fulminant Hepatic Failure in the Third Trimester of Pregnancy

Abstract

Disseminated Intravascular coagulation (DIC) is seen in other some clinical situations than obstetric disorders. Recently, the contribution of DIC to disordered hemostatic situation in fulminant hepatic failure has been appreciated.
In Japanese literature, 41 cases of fulminant hepatic failure in pregnancy have been reported, none of which have been studied in view of DIC. In world literature, only 2 cases, have been discussed about this condition.
In our report, a patient complicated by DIC with fulminant hepatic failure in pregnancy was presented, in whom serial blood coagulation studies were done, and the discussion about DIC and heparin therapy in fulminant hepatic failure was made.
Case Report: A 27 y. o., G3P1-0-1-1 Japanese woman, with a history of susp, systemic herpes virus hominis infection 3 months prior to this pregnancy, suddenly developed fulminant hepatic failure followed by DIC on 28 weeks pregnant. Mental disturbance and hemorrhagic diathesis progressed in spite of heparin therapy, fibrinogen and fresh blood transfusion etc.. Labor spontaneously occurred and resulted in a vaginal delivery of a male dead infant. In the immediate postpartum period, her general condition aggrevated suddenly. She sustained hepatic coma, severe dyspnea and cardiac arrhythmia, and died. No autopsy was done.