[Simulation of obstetrical disseminated intravascular coagulation (DIC) by scoring algorithm criteria established by the Japanese Association for Acute Medicine, the revised Japanese Ministry of Health and Welfare criteria and the International Society on Thrombosis and Haemostasis criteria].
BACKGROUND
Although obstetric disease is one of the major causes of disseminated intravascular coagulation (DIC), no gold standard exists. Three current criteria, the Japanese Association for Acute Medicine (JAAM) -DIC criteria, the revised Japanese Ministry of Health and Welfare (JMHW) criteria and the International Society on Thrombosis and Haemostasis (ISTH) criteria, do not clarify the usefulness in obstetric DIC. We therefore conducted a retrospective study by simulation.


METHODS
We enrolled 89 cases of emergent caesarean section when platelet count decreased to below 150,000 x 10(9) x mm(-3) during 7 days from 3 days before operation to 3 days after operation from April 2004 to March 2007. We applied them and compared diagnostic rates and investigated characteristics of obstetric DIC.


RESULTS
After excluding 21 cases, 68 cases were examined. The number of patients diagnosed with DIC by JAAM-DIC criteria, JMHW criteria and ISTH criteria were 15 (22.1%), 5 (7.4%) and 3 (4.4%), respectively. Fifteen patients who fulfilled JAAM-DIC criteria included all 5 patients for whom DIC was diagnosed by JMHW criteria, and those 5 patients included all 3 patients for whom DIC was diagnosed by ISTH criteria.


CONCLUSIONS
The current study indicates that JAAM-DIC criteria can be useful but may overdiagnose the DIC.
Sakurai
Yasuyoshi
Y
Department of Anesthesia, Social Insurance Funabashi Central Hospital, Funabashi.
Uchida
Michiko
M
Aiba
Junko
J
Mimura
Fumiaki
F
D002585:Cesarean Section; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis* / Q000209:etiology; D004630:Emergencies; D005260:Female; D006077:Government Agencies; D006801:Humans; D007390:International Agencies; D007564:Japan; D010976:Platelet Count; D011247:Pregnancy; D012015:Reference Standards; D012189:Retrospective Studies; D012955:Societies, Medical