How to treat and prevent dvs syndrome in pregnancy
Mar 20, 2018
The syndrome of disseminated intravascular coagulation is a reflection of the nonspecific reaction from the homeostasis. Usually in midwifery dvs syndrome in pregnancy manifests itself under the condition of severe blood loss, hemorrhagic shock, gestosis, placental abruption, sepsis and other complications of the pregnancy process.
This deviation indicates a violation of homeostasis - that is, the inability of the body to stop the bleeding. At the same time, blood coagulation occurs with the formation of aggregates of blood cells and clots blocking normal circulation. The consequence of such changes are serious dystrophic abnormalities in the work of the organs, supplemented by a deterioration in blood coagulability, a decrease in platelet count and heavy bleeding.
The rate of development and severity of the pathology may differ in a particular case. There are several forms of development:
- Lightning - for one hour.
- Acute - for hours.
- Podestroe - for several days.
- Chronic - for several months.
- Relapsing - the patient's condition is constantly exacerbated.
- Latent - latent course of pathology.
Most often this syndrome in pregnant women occurs in acute or chronic form. Chronic dvs syndrome in pregnancy develops due to concomitant cardiovascular diseases, blood diseases. Often against the background of the development of a chronic form of pathology in pregnant women begins nephropathy. The acute form is manifested due to severe blood loss.
Stages of development of pathology
DIC syndrome is classified into several stages of its development, namely:
- Hypercoagulation - increase in blood coagulability. It usually lasts from a few minutes to several days. Without special diagnostics in the laboratory, this stage can be latent. Its main external manifestations are: increased blood filling of the skin and its blueing, the formation of a marble pattern on the arms and legs, the development of rapid heart rate and chills.
- Hypocoagulation, not accompanied by an active process of dissolving thrombi and formed blood clots - reducing blood clotting. External signs of development of this stage are: severe bleeding from the operating wound or birth canal, nose bleeding, hemorrhage on the skin, hemorrhages on the lateral surface of the chest, on the hips and on the upper eyelid. Blood emitted from the uterus contains loosened clots, which are then quickly destroyed.
- Hypocoagulation, accompanied by an active process of dissolving blood clots and blood clots. External signs of this stage include: the release of liquid non-inverting blood, with the formation in rare cases of small clots that are very quickly destroyed. Develops bleeding from the uterus, from the injection site, in addition, the blood appears in the urine, hemorrhages in the abdominal cavity and sternum, as well as in the pericardium.
- The stage of complete blood coagulation - its duration is from seven to nine hours and longer.
In a severe neglected form, a dvs syndrome can have negative consequences for both the mother and the future child.
The treatment of dvs syndrome
How to treat dvs syndrome in pregnant women is solved by a hematologist while taking into account the main features of the stage of development of pathology. For the organization of an effective medical process, the doctor's advice and assistance from the midwife will be required.
When organizing the treatment of DIC syndrome, strict control of the main indicators should be carried out, which include:
- Introduction of oxygen into the arterial blood.
- Hourly diuresis.
- Detection of the level of proteins, creatinine and urea.
- Detection of the concentration of erythrocytes, platelets.
- Measurement of blood pressure indicators.
- Heart rate measurement.
The main rule of successful treatment is to eliminate the painful processes that occur in the body of a woman, and to get rid of the shock state. Progressing pathological processes contribute to the deterioration of the course of DIC syndrome, therefore, at the very beginning of therapy the main role is assigned to laboratory diagnosis of all phases of pathology, establishing its correlation with inflammation processes and infections, as well as with surgical interventions.
Assisting in stopping the subsequent development of DIC syndrome or significantly ease its course can eliminate the developed shock state.
To counteract the disease, the specialist prescribes complex transfusion treatment, which involves the intravenous administration of various medicaments in the form of solutions to normalize disturbances in homeostasis.
Prevention of dvs syndrome
For all pregnant women, it is necessary to organize a homeostasis examination for the timely diagnosis of disorders. The first and main signal for concern should be unsatisfactory results of blood tests for homeostasis.
Also, the dvs syndrome in gynecology is revealed through a study called a coagullogram. Such an analysis makes it possible to establish the presence and peculiarities of coagulation disorders in a woman in a position, as well as to reveal the complications of the pregnancy process present.
Coagulogram does once in three months, and if there is a slightest deviation in the appointment of a specialist more often. The blood for analysis is taken from the vein in the morning on an empty stomach. Diagnosis of severity of pathology helps to conduct timely and appropriate treatment.