A 34-year-old woman has just given birth to a healthy baby boy.After the delivery of the baby,the physician proceeds to deliver the placenta.After it has been extracted from the mother's uterus,the resident examines it and notes that it appears incomplete.They try to deliver the remainder but are unsuccessful.A few moments later,the mother loses consciousness,and is bleeding profusely from her uterus.Blood is collected,and the results follow. PT: 17 sec (RR: 11.3-12.8 sec)
INR: 3.02
APTT: 67 sec (RR: 23-32 sec)
D-dimer: 540 ng/mL (RR:

Question

A 34-year-old woman has just given birth to a healthy baby boy.After the delivery of the baby,the physician proceeds to deliver the placenta.After it has been extracted from the mother's uterus,the resident examines it and notes that it appears incomplete.They try to deliver the remainder but are unsuccessful.A few moments later,the mother loses consciousness,and is bleeding profusely from her uterus.Blood is collected,and the results follow. PT: 17 sec (RR: 11.3-12.8 sec)
INR: 3.02
APTT: 67 sec (RR: 23-32 sec)
D-dimer: 540 ng/mL (RR: <400 ng/mL)
Fibrinogen: 82 mg/dL (RR: 200-400 mg/dL)
Factor V assay: 12%
Based on this information,from what is the patient most likely suffering?

Quizplus · Accepted Answer

The patient is most likely suffering from disseminated intravascular coagulation (DIC), which is characterized by the consumption of clotting factors and platelets leading to bleeding. The prolonged PT, INR, and APTT, low fibrinogen levels, and elevated D-dimer levels are all indicative of a DIC. The low Factor V assay also supports the diagnosis of DIC as it is one of the first factors to be consumed in DIC. Hemophilia and von Willebrand's disease are both inherited disorders that result in bleeding, but the lab results do not support hemophilia because the APTT is prolonged and the factor V assay is low, which are not typical findings in hemophilia. Placenta previa is a condition in which the placenta covers the cervix, and it can cause bleeding during delivery, but it is not associated with the lab findings seen in this case.

A 34-Year-Old Woman Has Just Given Birth to a Healthy