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Differences between Japanese new criteria and pregnancy-specific modified ISTH DIC scores for obstetrical DIC diagnosis

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Abstract

The new Japanese diagnostic criteria for obstetrical disseminated intravascular coagulation (DIC) (tentative version) were released in June 2022. We aimed to demonstrate the differences in characteristics between women with DIC diagnosed using the new Japanese criteria and those diagnosed using the pregnancy-specific modified International Society on Thrombosis and Hemostasis DIC score, also known as the pregnancy-specific modified ISTH DIC score, which was released in 2014. In this retrospective cohort study, all participants were retrospectively diagnosed based on both criteria. Six women were diagnosed with obstetrical DIC based on both criteria (Group A). Of the 43 women diagnosed with obstetrical DIC based on the worldwide criteria, 36 were diagnosed with non-obstetrical DIC based on the new Japanese criteria (Group B). Group A had significantly lower fibrinogen levels and significantly higher prothrombin time differences and scores of underlying diseases (particularly postpartum hemorrhage with coagulopathy) and laboratory findings than Group B. Additionally, Group A had significantly higher rates of platelet concentrate (PC) transfusion therapy for obstetrical DIC and more transfusions of fresh frozen plasma and/or cryoprecipitate, red blood cells and PC than Group B. Thus, the new Japanese criteria detected more severe cases of obstetrical DIC compared with the worldwide criteria.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank Enago (www.enago.jp) for the English language review.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Kansai Medical University, Shinmachi 2-5-1, Hirakata, Osaka, 573-1010, Japan

    Mamoru Morikawa, Akio Kamiya, Aya Yoshida, Shuhei Nishibata & Hidetaka Okada

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  1. Mamoru Morikawa
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  2. Akio Kamiya
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  3. Aya Yoshida
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  4. Shuhei Nishibata
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  5. Hidetaka Okada
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Correspondence to Mamoru Morikawa.

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The authors declare that they have no conflict of interest.

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This study was approved by the Kansai Medical University Hospital Institutional Review Board (no. 2021053, accepted June 24, 2021).

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All study participants provided informed consent.

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Morikawa, M., Kamiya, A., Yoshida, A. et al. Differences between Japanese new criteria and pregnancy-specific modified ISTH DIC scores for obstetrical DIC diagnosis. Int J Hematol 119, 265–274 (2024). https://doi.org/10.1007/s12185-023-03702-y

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  • DOI: https://doi.org/10.1007/s12185-023-03702-y

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