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Disseminated intravascular coagulation — RCPSC IM MCQ

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HardHematologyDisseminated intravascular coagulationRCPSC IM

After placental abruption, a patient has uncontrolled bleeding, platelets 42 ×10⁹/L, INR 2.4, fibrinogen 0.7 g/L and markedly elevated D-dimer. Which action should be prioritized alongside hemorrhage control?

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Correct answer: B — Treat the cause and replace fibrinogen, platelets and coagulation factors

The best answer is “Treat the cause and replace fibrinogen, platelets and coagulation factors”. This is bleeding DIC from an obstetric catastrophe. Definitive hemorrhage control and balanced component replacement target the very low fibrinogen, thrombocytopenia and factor depletion; isolated vitamin K, immunosuppression, anticoagulation or delayed support cannot correct active consumptive bleeding.

Reference: Canadian Blood Services, blood components clinical guide: https://professionaleducation.blood.ca/en/transfusion/clinical-guide/blood-components