Question

Which of the clients would the nurse identify as being the greatest risk for developing disseminated intravascular coagulation (DIC)
1. A 4th gravida delivered 8 hours ago and has lost 500 mL of blood
2. A 2nd gravida diagnosed with dead fetus syndrome
3. A primigravida with mild pre-eclampsia
4. A primigravida who delivered a 3.5 kg baby 3 hours ago

Answer 1

Correct Answer - Option 2 : A 2nd gravida diagnosed with dead fetus syndrome

Explanation

• The DIC is the common cause of an abnormal hemorrhage during pregnancy and the puerperium.​

• It causes systemic activation of the coagulation by circulating thromboplastic material, after a secondary activation of the fibrinolytic system.​
• A potential cause for DIC is the retention of a highly macerated fetus after intrauterine fetal death or dead fetus syndrome.

​Other causes for DIC

• Abruptio placenta
• Eclampsia
• Retention of dead fetus
• Amniotic fluid embolism
• Placental retention
• Bacterial sepsis

​Diagnosis

• Fibrinogen level
• Platelet count
• PT and APTT
• Serum FDP