自2022年7月以来,日本的产科弥漫性血管内凝血(DIC)已根据新标准(暂定版本)进行诊断。评估主要的潜在疾病,纤维蛋白原水平,和纤维蛋白/纤维蛋白原降解产物或D-二聚体水平。2024年6月,暂定版本进行了小修订,最终版本发布。以前的日本标准评估潜在疾病,临床症状,和各种实验室发现。本研究旨在证明其有效性,可靠性,和新标准的有效性(最终版本)。我们分析了212例单胎妊娠妇女,这些妇女在22个妊娠周后分娩,阴道分娩时失血≥1000mL或剖宫产时失血≥2000mL。分娩时接受输血前实验室检查结果缺失的患者被排除在外。在产科DIC组中,纤维蛋白原水平<150mg/dL的频率显着高于对照组(90%vs.5%,p<0.0001),根据以前的日本标准,得分≥8的频率也是如此(100%与10%,p<0.0001)。Cronbachα为0.757,Spearman\的等级顺序相关性在新标准和以前的标准之间为0.558。总之,我们证明了有效性,可靠性,以及日本新标准(最终版本)诊断产科DIC的有效性。
Since July 2022, obstetrical disseminated intravascular coagulation (DIC) in Japan has been diagnosed based on the new criteria (tentative version), which assesses the main underlying disease, fibrinogen level, and fibrin/fibrinogen degradation products or D-dimer level. In June 2024, the tentative version underwent minor revision and the final version was released. The previous Japanese criteria assessed underlying disease, clinical symptoms, and various laboratory findings. This study aimed to prove the effectiveness, reliability, and validity of the new criteria (final version). We analyzed 212 women with singleton pregnancies who delivered after 22 gestational weeks and experienced blood loss ≥ 1000 mL during vaginal delivery or ≥ 2000 mL during cesarean section. Those with missing laboratory findings before receiving blood transfusion at delivery were excluded. In the obstetrical DIC group, the frequency of fibrinogen levels < 150 mg/dL was significantly higher than in the control group (90% vs. 5%, p < 0.0001), as was the frequency of scores ≥ 8 according to the previous Japanese criteria (100% vs. 10%, p < 0.0001). Cronbach alpha was 0.757 and Spearman\'s rank-order correlation was 0.558 between the new and previous criteria. In conclusion, we proved the effectiveness, reliability, and validity of the Japanese new criteria (final version) to diagnose obstetrical DIC.