In e na ional Clinical and Medical Case Repo s Jou nal
Case Repo (ISSN: 2832-5788)
In Clinc Med Case Rep Jou (ICMCRJ) 2025 | Volume 4 | Issue 11
Th ea ened Misca iage Resul ing in Dissemina ed In a ascula Coagulopa hy
(DIC)
Hala Yassin Hassan Maani1*, Ruwa Abdul Rahman Ba Madha 2
1Consul an Obs e ician and Gynecologis , MD Sudan , MRCOG , Ian Donald Diploma o Ul asound, Head o
Depa men o Obs e ics and Gynecology, ( UAE) Shaikh Khali a Medical Ci y, Shaikh Khali a Hospi al
Women and Child en , Uni ed A ab Emi a es.
2Specialis Obs e ician and Gynecologis , MRCOG, RCPI, Mas e o Science ( MSc) in Ul asound in
Gynecology and Obs e ics , Shaikh Khali a Medical Ci y , Shaikh Khali a Hospi al Women and Child en ,
Uni ed A ab Emi a es
Ci a ion: Hala Yassin Hassan Maani, Ruwa Abdul Rahman Ba Madha . Th ea ened Misca iage Resul ing in
Dissemina ed In a ascula Coagulopa hy (DIC). In Clinc Med Case Rep Jou . 2025;4(11):1-5.
Recei ed Da e: 04 No embe 2025; Accep ed Da e: 05 No embe 2025; Published Da e: 07 No embe 2025
*Co esponding au ho : Hala Yassin Hassan Maani ,Consul an Obs e ician and Gynecologis , MD Sudan ,
MRCOG , Ian Donald Diploma o Ul asound, Head O Depa men O Obs e ics and Gynecology , ( UAE)
Shaikh Khali a Medical Ci y , Shaikh Khali a Hospi al Women and Child en , Uni ed A ab Emi a es
Copy igh : Hala Yassin Hassan Maani, Open Access 2025. This a icle, published in In Clinc Med Case Rep
Jou (ICMCRJ) (A ibu ion 4.0 In e na ional), as desc ibed by h p://c ea i ecommons.o g/licenses/by/4.0/
ABSTRACT
Backg ound: This is a case o 23-yea -old lady 13 weeks DCDA win p egnancy admi ed wi h aginal
bleeding.
Case: He ans-abdominal sonog am de ec ed sub-cho ionic hema oma ha keeps inc easing in size du ing he
admission and he blood epo s e ealed a ull blown pic u e o DIC. Te mina ion o p egnancy by Dila a ion
and e acua ion was done a e ini ial esusci a ion wi h esh ozen plasma, pla ele concen a es,
c yop ecipi a e and ib inogen. She had an une en ul eco e y pe iod.
Conclusion: DIC is an ex emely li e- h ea ening condi ion which can occu as a e y in equen complica ion
o h ea ened misca iage.
INTRODUCTION
P imig a ida, dicho ionoc diamnio ic (DCDA) mul iple p egnancy a e o ula ion induc ion wi h h ea ened
misca iage esul ing in li e h ea ening dissemina ed in a ascula coagulopa hy (DIC).
In e na ional Clinical and Medical Case Repo s Jou nal
Case Repo (ISSN: 2832-5788)
In Clinc Med Case Rep Jou (ICMCRJ) 2025 | Volume 4 | Issue 11
CASE REPORT
A 23 yea old Asian p imig a ida diagnosed as h ea ened misca iage since 6 weeks p egnancy ollowing
o ula ion induc ion concep ion (due o social easons) a e only 4 mon hs o ac i ely ying o concei e. She
has no signi ican pas medical his o y.
She la e on p esen ed a 13 weeks wi h hea ie aginal bleeding and was admi ed o he hospi al. Ul asound
examina ion showed iable dicho ionic diamnio ic win p egnancy (DCDA) wi h sub-cho ionic hema oma
which was inc easing in size ill i occupied he whole ges a ional sac (Figu e 1,2,3,4,5,6).
The p egnancy was iable despi e he hea y bleeding and he inc ease in hema oma size, howe e he pa ien
de eloped DIC which was p o ed by lab in es iga ions ha showed inc eased PT/PTT, low hemoglobin, low
hema oc i , low ib inogen, ele a ed D-Dime wi h h ombocy openia.
She was o e ed e mina ion o p egnancy, howe e she was e y keen o con inue wi h he p egnancy, she
ecei ed mul iple blood ans usions bu she had con inuous aginal bleeding.
The DIC became wo se and inally a e ex ensi e counseling she ag eed o e mina ion o p egnancy.
She had su gical e acua ion o he p egnancy ollowed by inse ion o bak i balloon, In a- ope a i e blood loss
was 1500 ml, and she ecei ed 10 uni s o esh ozen plasma, 10 uni s o c yop ecipi a e, 6 uni s o pla ele s, 2
g ams ib inogen and she was kep in he ICU o 1 day.
Bak i balloon was emo ed on day 2 and he pa ien was discha ged on day 3 pos - ope a i e on o al i on.
He ollow up a e 4 weeks was un ema kable.
Figu e 1: The p egnancy showing he hema oma on he le win sac
In e na ional Clinical and Medical Case Repo s Jou nal
Case Repo (ISSN: 2832-5788)
In Clinc Med Case Rep Jou (ICMCRJ) 2025 | Volume 4 | Issue 11
Figu e 2: Sub cho ionic hemo hage along le win placen a
Figu e 3 and 4: The Hema oma wi h colo Dopple
Figu e 5 and 6: The hema oma almos obli e a ing he ges a ional age
In e na ional Clinical and Medical Case Repo s Jou nal
Case Repo (ISSN: 2832-5788)
In Clinc Med Case Rep Jou (ICMCRJ) 2025 | Volume 4 | Issue 11
DISCUSSION
Dissemina ed in a ascula coagula ion (DIC) is an acqui ed synd ome cha ac e ized by he in a ascula
ac i a ion o coagula ion wi h loss o localiza ion a ising om di e en causes. I can o igina e om and cause
damage o he mic o ascula u e, which, i su icien ly se e e, can p oduce o gan dys unc ion [1]. The esul an
clinical condi ion is cha ac e ized by in a ascula coagula ion and hemo hage. The a ec ed pe son is o en
acu ely ill and shocked wi h widesp ead hemo hage (common bleeding si es a e mou h, nose, and enepunc u e
si es), ex ensi e b uising, enal ailu e, and gang ene. DIC usually p esen s as an acu e, o en ca as ophic,
acqui ed hemo hagic endency. Ra ely can i also mani es as a low-g ade diso de wi h p edominan ly
h ombo ic mani es a ions [2].
Dissemina ed In a ascula Coagula ion Synd ome de elops in app oxima ely 0.03-0.35% o p egnancies
o e all and has a epo ed p e alence o 12.5 pe 10,000 deli e y hospi aliza ions [3]. The p e alence o
p egnancy-associa ed DIC is low, pa ien s wi h speci ic p egnancy complica ions, such as amnio ic luid
embolism o placen al ab up ion as in his pa ien (p esen ed as sub-cho ionic hemo hage), can be a e y high
isk wi h a p e alence o >20% [4].
DIC is cha ac e ized by a concomi an o e -ac i a ion o he coagula ion and ib inoly ic sys ems, [5]. Leading o
widesp ead mic o ascula h ombosis, dis up ion o blood supply o di e en o gans, ischemia, and mul i-o gan
ailu e. This ex ensi e ac i a ion o he coagula ion cascade leads o consump ion and deple ion o pla ele s and
coagula ion p o eins, which can p o oke concu en se e e bleeding [6]. o no e, obs e ic DIC mo e ypically
p esen s wi h bleeding complica ions, a he han h ombo ic complica ions
Ea ly p egnancy bleeding emains a cause o ma e nal mo bidi y and mo ali y i no managed ca e ully and
can be complica ed by DIC. Case selec ion o o ula ion induc ion should be based on s ic c i e ia and should
only be conside ed in cases whe e he e has been p o en sub e ili y as pe na ional and in e na ional guidelines.
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In e na ional Clinical and Medical Case Repo s Jou nal
Case Repo (ISSN: 2832-5788)
In Clinc Med Case Rep Jou (ICMCRJ) 2025 | Volume 4 | Issue 11
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