A woman with severe preeclampsia at 34 weeks develops abruptio placentae and delivers a stillborn. Six hours postpartum she has oozing from the IV site and ecchymosis. Platelet count is 60,000/cu mm, fibrinogen is 120 mg/dL, and D-dimer is elevated. What is the most likely diagnosis?

• A Disseminated intravascular coagulation ✓
• B HELLP syndrome
• C Idiopathic thrombocytopenic purpura
• D Vitamin K deficiency

Explanation

Abruptio placentae is a classic trigger for DIC. The combination of thrombocytopenia, low fibrinogen, elevated D-dimer, and bleeding from sites confirms consumptive coagulopathy. HELLP may coexist but does not explain the low fibrinogen and elevated D-dimer. ITP and vitamin K deficiency do not fit this acute consumptive picture.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.