O46.021 Antepartum hemorrhage with disseminated intravascular coagulation, first trimester

ICD10CM code

#### Name of the Condition
- Antepartum Hemorrhage with Disseminated Intravascular Coagulation, First Trimester
- O46.021

#### Summary
Antepartum hemorrhage refers to bleeding from the genital tract during pregnancy, typically after 20 weeks of gestation. However, bleeding in the first trimester can also occur and be associated with disseminated intravascular coagulation (DIC), a condition causing blood clots to form throughout the body's small blood vessels.

#### Causes
The causes of antepartum hemorrhage in the first trimester can include miscarriage, ectopic pregnancy, or conditions such as placental abruption. DIC is often triggered by severe complications such as sepsis, trauma, or other conditions that lead to systemic inflammation.

#### Risk Factors
- Advanced maternal age
- History of miscarriages
- Previous cases of hemorrhage in pregnancy
- Smoking and substance abuse
- Hypertension or preexisting clotting disorders

#### Symptoms
- Vaginal bleeding
- Abdominal pain or cramping
- Signs of DIC may include bruising, excessive bleeding from injuries, rapid heartbeat, or decreased blood pressure.

#### Diagnosis
- Ultrasound to assess pregnancy status
- Blood tests including complete blood count and coagulation screening
- Monitoring of fetal heart rate if applicable

#### Treatment Options
- Stabilization of the mother's condition first using intravenous fluids and blood products as needed
- Treating the underlying cause of the bleeding and DIC, which may include surgery in severe cases such as ectopic pregnancy
- Monitoring and supporting vital functions

#### Prognosis and Follow-Up
Early intervention can often control the hemorrhage and manage DIC. Regular follow-ups are crucial to monitor maternal health and pregnancy progression, ensuring both are stable.

#### Complications
- Uncontrolled bleeding leading to maternal shock
- Fetal loss in severe cases
- Organ damage due to DIC, affecting kidneys and liver

#### Lifestyle & Prevention
- Regular prenatal check-ups
- Avoidance of alcohol, tobacco, and illicit drugs
- Managing underlying health conditions such as hypertension and diabetes

#### When to Seek Professional Help
- Experiencing heavy bleeding or clotting
- Severe abdominal pain
- Signs of shock such as dizziness, fainting, or rapid heartbeat
- Immediate medical evaluation is critical in these cases

#### Additional Resources
- American Pregnancy Association [www.americanpregnancy.org](https://www.americanpregnancy.org)
- March of Dimes [www.marchofdimes.org](https://www.marchofdimes.org)

#### Tips for Medical Coders
- Confirm first trimester status to ensure accurate coding with O46.021.
- Distinguish between antepartum hemorrhage with and without DIC to avoid misclassification.
- Cross-reference with other relevant maternal codes if complications are present.

Medical Policies and Guidelines for Antepartum hemorrhage with disseminated intravascular coagulation, first trimester

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