A woman with severe placental abruption develops oozing from the venipuncture site, hematuria, and a falling platelet count with prolonged PT and aPTT. The primary mechanism linking abruption to this coagulopathy is:

• A Release of tissue factor and thromboplastin from the retroplacental clot into the maternal circulation ✓
• B Immune-mediated platelet destruction by maternal antibodies
• C Direct consumption of clotting factors by the exposed amniotic fluid
• D Bone marrow suppression by prostaglandins released from the placenta

Explanation

Abruptio placentae is the classic obstetric cause of consumptive coagulopathy. Thromboplastin and other procoagulants released from the disrupted retroplacental hematoma and damaged decidua enter the maternal circulation, triggering widespread intravascular fibrin deposition and consumption of platelets and factors V and VIII. Amniotic fluid embolism also causes DIC but through a different trigger, and it presents with sudden cardiorespiratory collapse rather than abruption pain.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.