A 34-year-old G2P1 at 32 weeks presents with severe epigastric pain, vomiting, and blurred vision. Blood pressure is 160/110 mmHg, platelets 80,000/cu mm, LDH 600 U/L, AST 150 U/L. She develops disseminated intravascular coagulation. Which coagulation abnormality is the earliest laboratory indicator of DIC in this clinical setting?

• A Prolonged prothrombin time
• B Elevated D-dimer
• C Decreased fibrinogen
• D Thrombocytopenia ✓

Explanation

Thrombocytopenia is the earliest and most consistent coagulation abnormality in DIC associated with HELLP syndrome. Platelet consumption occurs before significant fibrinogen depletion or PT prolongation. D-dimer is elevated but is a marker of fibrinolysis, not the earliest indicator of consumption. Fibrinogen falls later in established DIC.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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