A patient at 17 weeks gestation is diagnosed as having an intrauterine fetal demise. She returns to your clinic 5 weeks later and has not had amiscarriage, although she has had some occasional spotting. This patient is at increased risk for
Correct Answer: Consumptive coagulopathy with hypofibrinogenemia
Description: (Gleicher, 3/e, p 1153.) In modern clinical medicine, once the diagnosis of fetal demise has been made, the products of concep tion are removed. If, however, the gestational age is over 14 weeks and the fetal death occurred 5 weeks ago, coagulation abnormalities may be seen. Septic aboions were more frequently seen during the era of illegal aboions, although occasionally sepsis can occur if there is incomplete evacuation of the products of conception in either a therapeutic or spontaneous aboion.
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