Which combination best suggests DIC in obstetric hemorrhage?

Which combination best suggests DIC in obstetric hemorrhage?

• A. Prolonged bleeding with abnormal coagulation tests; prolonged PT/aPTT; low platelets; low fibrinogen.
• B. Elevated WBC.
• C. Normal coagulation tests.
• D. Hypercoagulable state without bleeding.

Answer: (A)

DIC in obstetric hemorrhage is a consumptive coagulopathy where widespread activation of clotting uses up platelets and clotting factors, leading to a bleeding tendency and abnormal coagulation labs. The best signal is a pattern of abnormal coagulation tests with evidence of consumption: prolonged PT and aPTT indicate depleted clotting factors; low platelets reflect platelet consumption; low fibrinogen shows consumption of a key clotting protein. In obstetric DIC, this combination matches the classic lab picture of a bleeding, consumptive process driven by massive activation of coagulation. Other choices don’t fit this scenario: elevated white blood cell count points toward infection rather than a consumptive coagulopathy; normal coagulation tests would not explain the bleeding risk in DIC; a hypercoagulable state without bleeding describes a prothrombotic condition without the consumption and bleeding seen in DIC.

DIC in obstetric hemorrhage is a consumptive coagulopathy where widespread activation of clotting uses up platelets and clotting factors, leading to a bleeding tendency and abnormal coagulation labs. The best signal is a pattern of abnormal coagulation tests with evidence of consumption: prolonged PT and aPTT indicate depleted clotting factors; low platelets reflect platelet consumption; low fibrinogen shows consumption of a key clotting protein. In obstetric DIC, this combination matches the classic lab picture of a bleeding, consumptive process driven by massive activation of coagulation.

Other choices don’t fit this scenario: elevated white blood cell count points toward infection rather than a consumptive coagulopathy; normal coagulation tests would not explain the bleeding risk in DIC; a hypercoagulable state without bleeding describes a prothrombotic condition without the consumption and bleeding seen in DIC.