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Table 1 Obstetric DIC score

From: The efficacy of recombinant human soluble thrombomodulin for obstetric disseminated intravascular coagulation: a retrospective study

 

Score

1. Underlying diseases

 

 a. Placental abruption

 

  Stiffening of the uterus, death of the fetus

5

  Stiffening of the uterus, survival of the fetus

4

  Confirmatory diagnosis of placental abruption by ultrasonic tomographic findings and CTG findings

4

 b. Amniotic fluid embolism

 

  Acute cor pulmonale

4

  Artificial ventilation

3

  Assisted respiration

2

  Oxygen flux alone

1

 c. DIC-type postpartum hemorrhage

 

  In case the blood from the uterus has low coagulability

4

  Hemorrhage of >2000 mL (within 24 hours after the start of hemorrhage)

3

  Hemorrhage of 1000–2000 mL (within 24 hours after the start of hemorrhage)

1

 d. Eclampsia

 

  Eclamptic attack

4

 e. Severe infection

 

  Those with fever accompanied by shock, bacteremia, and endotoxemia

4

  Continued fever or remittent fever

1

 f. Other underlying diseases

1

2. Clinical symptoms

 

 a. Acute renal failure

 

  Anuria (<5 mL/hour)

4

  Oliguria (5–20 mL/hour)

3

 b. Acute respiratory failure (amniotic fluid embolism excluded)

 

  Artificial ventilation or occational assisted respiration

4

  Oxygen flux alone

I

 c. Organ failure

 

  Heart (rales or foamy sputum, etc.)

4

  Liver (visible jaundice, etc.)

4

  Brain (clouding of consciousness, convulsion, etc.)

4

  Digestive tract (necrotic enteritis, etc.)

4

  Other severe organ failure

4

 d. Hemorrhage diathesis

 

  Macroscopic hematuria and melena, purpura, etc.

4

 e. Shock symptoms

 

  Pulse rate ≥100/minute

1

  Blood pressure ≤90 mm Hg (systolic) or reduction ≥40 %

1

  Cold sweat

1

  Pallor

1

3. Laboratory findings

 

  Serum FDP ≥10 pg/mL

1

  Platelet counts ≤100 × 109/L

1

  Fibrinogen ≤150 mg/dL

1

  PT ≥15 seconds (≤50 %) or hepaplastin test ≤ 50 %

1

  Erythrocyte sedimentation rate of ≤4 mm/15 minutes or ≤15 mm/hour

1

  Bleeding time ≥5 minutes

1

  Other coagulation and fibrinolysis factors;

 

  antithrombin ≤18 mg/dL or ≤60 %, plasminogen, prekallikrein, other factors of ≤50 %

1

Diagnosis

 

8–12 points

Suspected DIC

≥13 points

Definite DIC

  1. DIC disseminated intravascular coagulation, CTG cardiotocography, FDP fibrin/fibrinogen degradation products, PT prothrombin time