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DISSEMINATED INTRAVASCULAR COAGULATION IN THE THIRD TRIMESTER FOLLOWING INTRAUTERINE FETAL DEMISE : MATERNAL NEAR MISS - CASE REPORT INTRODUCTION : Disseminated intravascular coagulation is a life-threatening event that is the endpoint of a pathologically activated cascade leading to excessive consumption of platelets culminating in bleeding. Several diseases are known to be associated with DIC, some of which may also occur during pregnancy and puerperium. One of the the potential risk factors that have been considered as a potential trigger for DIC is the retention of a highly macerated foetus after intrauterine fetal demise. CASE STUDY : A 27 year old female with diagnosis of G4P3L3 with 33 weeks of gestation with cephalic presentation with previous 2 LSCS with Intrauterine fetal demise was admitted. Patient was induced and delivered vaginally. Approximately 2 hours following delivery , patient was noted to have significant vaginal bleeding. Patient became hemodynamically unstable and went into hypovolemic shock. Patient was shifted to OT with inotrope support and blood transfusion on flow. Exploratory laparotomy was done and source of bleeding could not be found . Diagnosis of Disseminated Intravascular coagulation was made because of deranged coagulation profile. Massive blood transfusion protocol was started. Around 3500 ml volume of blood and blood products were transfused over 24 hrs. Peripheral pulses were not felt for 12 hours and was put on 4 inotropes. Patient was intubated for 3 days, with inotrope support and anuria for 3 days and underwent 5 cycles of dialysis. The patient was uneventfully discharged after complete recovery. CONCLUSION: The diagnosis of DIC can be elusive during pregnancy and requires vigilance and knowledge of the physiologic changes during pregnancy. Management of DIC during pregnancy requires a prompt attention to the underlying condition leading to this complication, including the delivery of the patient, and correction of the hemostatic problem.