Obstetrics & Gynaecology · Antepartum and Postpartum Hemorrhage

A patient with severe preeclampsia at 34 weeks develops abruptio placentae. Laboratory tests show platelet count 80,000/cu mm, fibrinogen 120 mg/dL, and prolonged PT/APTT. The most likely complication is:

  • A Disseminated intravascular coagulation
  • B HELLP syndrome
  • C Acute fatty liver of pregnancy
  • D Thrombotic thrombocytopenic purpura
Correct answer: A. Disseminated intravascular coagulation

Explanation

Abruptio placentae releases thromboplastin into maternal circulation, triggering DIC. The triad of thrombocytopenia, hypofibrinogenemia, and prolonged clotting times is diagnostic of DIC. HELLP syndrome causes hemolysis, elevated liver enzymes, and low platelets but not hypofibrinogenemia. Acute fatty liver causes hepatic failure. TTP causes neurological symptoms and fever.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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