Abstract

Introduction: Disseminated Intravascular Coagulation (DIC) is a severe complication of Postpartum Hemorrhage (PPH) and a major cause of maternal mortality. This study aimed to identify factors associated with DIC in women with PPH. Materials and methods: A retrospective analytical case-control study was conducted from January 2020 to December 2024 Androva University Hospital, Mahajanga (Madagascar). Cases were parturients with DIC complicating PPH, while controls had PPH without DIC (1:3 ratio). Sociodemographic, obstetrical, clinical, biological, management, and maternalfetal outcome data were analyzed using SPSS version 26. Statistical significance was set at p < 0.05. Results: Eighty-eight parturients were included (22 cases, 66 controls). Systolic blood pressure <90 mmHg (OR = 19.11; p = 0.003), was significantly associated with DIC. Uterine atony was significantly associated with DIC (OR = 5.57; p = 0.001). Hemoglobin <70 g/L, thrombocytopenia <150 G/L, and prothrombin time <70% were also associated with DIC. Maternal mortality was significantly higher in cases (81.82% vs 9.09%; p < 0.001). Conclusion: DIC complicating PPH is associated with severe clinical and biological abnormalities and high maternal mortality, highlighting the need for early diagnosis and prompt multidisciplinary management.

Keywords: Disseminated intravascular coagulation, Risk factors, Postpartum hemorrhage, Maternal mortality, Obstetrics