A 29-year-old secundigravida with twin gestation required cesarean section at 39 weeks' gestation because of severe bradycardia of the second twin. Her BP had risen from 110/60 mmHg on admission to 140/90 mmHg at 5 cm dilation of the cervix. The operation performed under general anesthesia was uneventful except for increased oozing from uterine and dermal incisions. Clotting function tests were within normal limits. Three hours after surgery, HR rose to 140 beats/min, hematocrit and hemoglobin declined to 19.5% and 6.5 mg/dl respectively, and thrombocytes fell to 20,000/mm3. PT was 24 sec, aPTT was 124 sec and fibrinogen 74 mg/dl. Treatment with packed cells, fresh-frozen plasma, cryoprecipitate and platelets ameliorated the clotting disturbance. Oliguria appeared 10 hours after operation and blood urea nitrogen rose to 9.6 mmol/l. Jaundice developed with total serum bilirubin of 197 mmol/1 and blood glucose of 1.2 mmol/1. Twenty-four hours later, the abdomen became increasingly distended; on laparotomy, 2,000 ml of bloody fluid was removed from the peritoneal cavity and the liver was enlarged, hard, and darkly discolored. Blood replacement was adequate. Peritoneal dialysis was started, liver enzyme levels began to rise markedly; metabolic acidosis was severe. The patient died on the 4th postoperative day in a state of active DIC with fulminant hepatorenal failure.