The DOI matches its Crossref record; 93 of the 93 references it cites were found in a registry or an index.
DIC score in pregnant women–a population based modification of the International Society on Thrombosis and Hemostasis score
Open accessAbstract
OBJECTIVES: The objectives of this study were: 1) To determine the component needed to generate a validated DIC score during pregnancy. 2) To validate such scoring system in the identification of patients with clinical diagnosis of DIC. MATERIAL AND METHODS: This is a population based retrospective study, including all women who gave birth at the 'Soroka University Medical Center' during the study period, and have had blood coagulation tests including complete blood cell count, prothrombin time (PT)(seconds), partial thromboplastin time (aPTT), fibrinogen, and D-dimers. Nomograms for pregnancy were established, and DIC score was constructed based on ROC curve analyses. RESULTS: 1) maternal plasma fibrinogen concentrations increased during pregnancy; 2) maternal platelet count decreased gradually during gestation; 3) the PT and PTT values did not change with advancing gestation; 4) PT difference had an area under the curve (AUC) of 0.96 (p<0.001), and a PT difference ≥1.55 had an 87% sensitivity and 90% specificity for the diagnosis of DIC; 5) the platelet count had an AUC of 0.87 (p<0.001), an 86% sensitivity and 71% specificity for the diagnosis of DIC; 6) fibrinogen concentrations had an AUC of 0.95 (p<0.001) and a cutoff point ≤3.9 g/L had a sensitivity of 87% and a specificity of 92% for the development of DIC; and 7) The pregnancy adjusted DIC score had an AUC of 0.975 (p<0.001) and at a cutoff point of ≥26 had a sensitivity of 88%, a specificity of 96%, a LR(+) of 22 and a LR(-) of 0.125 for the diagnosis of DIC. CONCLUSION: We could establish a sensitive and specific pregnancy adjusted DIC score. The positive likelihood ratio of this score suggests that a patient with a score of ≥26 has a high probability to have DIC.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Abruption is the most common cause of DIC in pregnancy (93, 94).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [93]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Scoring systems such as the International Society of Thrombosis and Hemostasis DIC Score (101) was modified for pregnancy (93)(TABLE 6).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [93]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Taylor, F., Toh, C.-H., Hoots, K., Wada, H., & Levi, M. (2001) · Thrombosis and Haemostasis · doi:10.1055/s-0037-1616068 · Cited by 2,285 · cited 10×
“The fourth component of the ISTH overt DIC score is the concentrations of D-dimer or fibrin split products [28].”
BackgroundMethodInfluentialDisseminated Intravascular Coagulation
Levi, M. M., & Cate, H. T. (1999) · New England Journal of Medicine · doi:10.1056/nejm199908193410807 · Cited by 2,035
Guidelines for the diagnosis and management of disseminated intravascular coagulation
Levi, M. M., Toh, C., Thachil, J. V., & Watson, H. G. (2009) · British Journal of Haematology · doi:10.1111/j.1365-2141.2009.07600.x · Cited by 1,116
Sibai, B. M., Ramadan, M. K., Usta, I. M., Salama, M., Mercer, B. M., & Friedman, S. A. (1993) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(93)90043-i · Cited by 1,080 · cited 2×
“However, thrombocytopenia is a hallmark of severe pregnancy complications such as preeclampsia and hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome [41,49,50,71–76].”
BackgroundHaemostatic changes in pregnancy
Bremme, K. A. (2003) · Best Practice & Research Clinical Haematology · doi:10.1016/s1521-6926(03)00021-5 · Cited by 871
d -Dimer for the Exclusion of Acute Venous Thrombosis and Pulmonary Embolism
Stein, P. D., Hull, R. D., Patel, K. C., Olson, R. E., Ghali, W. A., Brant, R., Biel, R. K., Bharadia, V., & Kalra, N. K. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-140-8-200404200-00005 · Cited by 797 · cited 1×
“5 mg/L is considered as the upper limit of the normal value in non-pregnant patients [80–82].”
BackgroundSeptic Shock, Multiple Organ Failure, and Disseminated Intravascular Coagulation
Fourrier, F., Chopin, C., Goudemand, J., Hendrycx, S., Caron, C., Rime, A., Marey, A., & Lestavel, P. (1992) · CHEST Journal · doi:10.1378/chest.101.3.816 · Cited by 706
British Thoracic Society guidelines for the management of suspected acute pulmonary embolism
(2003) · Thorax · doi:10.1136/thorax.58.6.470 · Cited by 687
Pregnancy-Related Mortality in the United States, 1998 to 2005
Berg, C. J., Callaghan, W. M., Syverson, C. J., & Henderson, Z. (2010) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e3181fdfb11 · Cited by 685
Gando, S., Iba, T., Eguchi, Y., Ohtomo, Y., Okamoto, K., Koseki, K., Mayumi, T., Murata, A., Ikeda, T., Ishikura, H., et al. (2006) · Critical Care Medicine · doi:10.1097/01.ccm.0000202209.42491.38 · Cited by 647 · cited 4×
“Moreover, it was also associated with a good survival prediction of non-pregnant patients hospitalized in intensive care units [52,83,84].”
BackgroundMethodInfluential
Flagged first, then by citations
Research works printed but not linked: 1
- 2003, Thorax, Thorax, 58, 470
Cited by
Sorted by citations
Items 101–146 of 146
The Placenta as a Critical Care Issue
Fox, K. A., Rac, M. W. F., Shamshirsaz, A. A., & Belfort, M. A. (2018) · Wiley eBooks · doi:10.1002/9781119129400.ch49
Endovascular Balloon Occlusion in Obstetrical Hemorrhage
Fox, K. A. (2019) · Hot topics in acute care surgery and trauma · doi:10.1007/978-3-030-25341-7_11
The Mean Difference of Hemostatic Factors in Severe Preeclampsia and Eclampsia
Setia, D. P., Ferry, F., & Djanas, D. (2020) · Andalas obstetrics and gynecology journal · doi:10.25077/aoj.4.1.22-27.2020
Turgut, A., Peker, N., Ağaçayak, E., Evsen, G. A., AYDIN, E., İçen, M. S., Karaçor, T., Fındık, F. M., Çelik, F., Dirican, E., et al. (2020) · Dicle Medical Journal / Dicle Tip Dergisi · doi:10.5798/dicletip.799622
Aslan, Ö., Gürbulak, K., Kara, U., Erkan, S. A. Y., Canooğlu, E., & Abay, M. (2021) · Erciyes Üniversitesi Veteriner Fakültesi Dergisi · doi:10.32707/ercivet.952884
“In women, to assists in the diagnosis and the identification of patients at risk for the development of DIC, coagulation assays including PT, PTT, fibrinogen and D-dimer or fibrin split products are used (Erez et al., 2014).”
MethodMOF in Pregnancy and Its Relevance to Eclampsia
Barbagallo, M., & Schiappa, E. (2022) · Hot topics in acute care surgery and trauma · doi:10.1007/978-3-030-92241-2_17
Fox, K. A. (2021) · Springer eBooks · doi:10.1007/978-3-030-56338-7_12
Clark, S. L., Romero, R. J., Belfort, M. A., & Dildy, G. A. (2017) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2017.04.010
The Mean Difference of Hemostatic Factors in Severe Preeclampsia and Eclampsia
Setia, D. P., Ferry, F., & Djanas, D. (2020) · Andalas obstetrics and gynecology journal · doi:10.25077/aoj.4.1.25-30.2020
Shih, A. W. Y., Li, N., Montemayor, C., & Heddle, N. M. (2022) · doi:10.1002/9781119665885.ch49
Keleş, A., AYDOĞMUŞ, S., CELİK, O. Y., Dağdeviren, G., Obut, M., Çelen, Ş., & Çağlar, A. T. (2022) · Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi · doi:10.20492/aeahtd.1110017
(2023) · PubMed Central · doi:10.3760/cma.j.issn.0253-2727.2023.08.002
“[1] Erez O, Novack L, Beer-Weisel R, et al.”
Li, H., li, W., Xu, T., Chen, Q. L., Cai, M., Hu, K., Shi, J., Li, M., & Peng, J. (2024) · Research Square · doi:10.21203/rs.3.rs-3769948/v1
Chou, T., Thakur, A., & Singh, K. N. (2024) · The Journal of Obstetrics and Gynecology of India · doi:10.1007/s13224-023-01928-8
Kontorshchikov, A. S., Кунижева, М. А., Batrakova, E. P., Jafarova, Z. B., Vasyukova, O. A., Karpushov, S. A., Varyasin, V. V., Berezhnaya, E. E., Kakturskiy, L., & Михалева, Л. М. (2024) · CLINICAL AND EXPERIMENTAL MORPHOLOGY · doi:10.31088/cem2024.13.1.14-23
Kim, S. M., Sohn, C. H., Kwon, H., Ryoo, S. M., Ahn, S., Seo, D. W., & Kim, W. Y. (2024) · Journal of Personalized Medicine · doi:10.3390/jpm14040422
“The ISTH DIC score was calculated using modified criteria associated with pregnancy, as previous research suggested, i.e., a pregnancy-modified ISTH DIC score ≥ 26 [19].”
MethodCoagulopathy parameters in symptomatic and asymptomatic Pregnant Women with COVID-19
Pelin, A.-M., Maftei, N.-M., Georgescu, C., Roşca, Ș., Gunache, R. O., Pelin, I., & Ștefănescu, C. (2024) · Technium BioChemMed · doi:10.47577/biochemmed.v8i.10893
“Moreover, in addition to routine measurement of D-dimers, prothrombin time and platelet counts in all patients with COVID-19, according to the guidelines of the International Society on Thrombosis and Haemostasis (ISTH), monitoring of APTT and fibrinogen levels must be considered (10,11).”
MethodProbable acute fatty liver of pregnancy presenting with dyspnoea and ground-glass opacities
Pathmanathan, U., Alamein, C., & Morton, A. (2024) · Obstetric Medicine · doi:10.1177/1753495x241261115
“21 Additionally, the woman did not manifest sudden cardiopulmonary collapse or signi fi cant hypotension.”
Noninvasive Monitoring in Critical Care
Easter, S. R. (2024) · Wiley eBooks · doi:10.1002/9781119820260.ch20
Gerinnungsstörungen in der Geburtshilfe
Rath, W. H., Bergmann, F., & Korte, W. C. (2024) · Springer Reference Medizin · doi:10.1007/978-3-662-63506-3_41
Disseminated Intravascular Coagulation (DIC)
Nayak, B., & Behura, S. S. (2024) · Springer eBooks · doi:10.1007/978-981-97-5565-3_18
Acquired Bleeding Disorders: Haemostatic Management in Pregnancy and Postpartum
Saleem, Z., Erez, O., Luvaton, S., Curry, N., & Kadir, R. A. (2025) · Springer eBooks · doi:10.1007/978-3-031-89214-1_10
Consumption and dilutional coagulopathy in critically ill obstetric patient
Hannan, W., Leon, R. M. S., & Hsu, S. H.-L. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-21435-6.00001-x
Tomoaki, O. D. A. (2025) · Japanese Journal of Thrombosis and Hemostasis · doi:10.2491/jjsth.36.516
Disseminated intravascular coagulation in pregnancy: a case report
Lalu, A. M., & Mathew, R. M. (2025) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.18203/2320-1770.ijrcog20252761
Adıgüzel, F. I., Öztoprak, Y., Nessar, A. Z., Uysal, G., Kükrer, S., Adıgüzel, C., & Narin, R. (2025) · International Journal of General Medicine · doi:10.2147/ijgm.s547628
“10,11 In addition, decreased fibrinogen levels in individuals with placental abruption appear to be related to the severity of the disease.”
Ağaoğlu, R. T., Ergani, S. Y., Kurt, D. S., Hızlı, B., Öztürk, Ö., Kından, A., Akbulut, Ö. V., Turmuş, E. G., Şeyhanlı, Z., & Yücel, K. Y. (2025) · Bratislavské lekárske listy/Bratislava medical journal · doi:10.1007/s44411-025-00334-y
“A total score of 26 points or higher was considered diagnostic for DIC [12].”
Chen, J., Huang, Z., Fan, X., Hu, X.-W., Qi, M., Liao, C.-J., Long, L.-Y., & Huang, Y. (2020) · Figshare · doi:10.6084/m9.figshare.13065671
Chen, J., Huang, Z., Fan, X., Hu, X.-W., Qi, M., Liao, C.-J., Long, L.-Y., & Huang, Y. (2020) · Figshare · doi:10.6084/m9.figshare.13065668
Aslan, Ö., Gürbulak, K., Kara, U., Erkan, S. A. Y., Canooğlu, E., & Abay, M. (2021) · DergiPark (Istanbul University)
Platelets in pregnancy - protector or adversary?
Gurumurthy, G., Erez, O., & Thachil, J. V. (2026) · Thrombosis Research · doi:10.1016/j.thromres.2026.109662
Kamidani, R., & Okada, H. (2026) · Thrombosis Research · doi:10.1016/j.thromres.2026.109694
Misirlioglu, R., Güleroğlu, F. Y., & Cetin, A. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15093524 · Cited by 1
“Erez et al. developed a pregnancy-adjusted DIC score to account for gestational changes in hemostasis and reported that a score of ≥ 26 was associated with a high probability of https://doi.org/10.3390/jcm15093524 DIC [13].”
InfluentialKeasler, P. M. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-21917-7.00025-2
Hemostasis and Disseminated Intravascular Coagulation
Amirkhosravi, A., & Ruokonen, H. (2026) · Springer eBooks · doi:10.1007/978-3-032-21069-2_4
Riddell, N. S., Barrett, L., Curry, N., Mutch, N. J., Collis, R. E., Collins, P. W., Bell, S. F., & de Lloyd, L. (2026) · British Journal of Anaesthesia · doi:10.1016/j.bja.2026.05.006
Erez, O., Besser, L., Schwartz, A. D., Illanes, S. E., Quezada, B., Othman, M., Kadir, R. A., Iba, T., Sidonio, R. F., Scărlătescu, E., et al. (2026) · Journal of Thrombosis and Haemostasis · doi:10.1016/j.jtha.2026.06.030
Coagulation Disorders in Obstetrics
Rath, W. H., Bergmann, F., & Korte, W. C. (2026) · Springer eBooks · doi:10.1007/978-3-662-70578-0_55
A New Severity Index for Placental Abruption Predicts Recurrence Risk in Future Pregnancies
Kerber, L., Rippel, S., Cohen, O., Rokach, L., Spiegel, E., Avnon, T., & Erez, O. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15135308
Tada, K., Miyagi, Y., Yasuhi, I., Tsumura, K., Emoto, I., Sagawa, M., Tanaka, N., Yamaguchi, K., Maeda, K., & Kawakami, K. (2026) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-026-09762-2
“For PPH management, it has been reported that fibrinogen 200 mg/dL is a predictive marker of worsening bleeding [17, 18, 19] and that fibrinogen and FDP are essential parameters for diagnosing DIC [7, 20, 21].”
Pathogenetic link between postpartum hemorrhage and renal cortical necrosis
Kumar, A. (2026) · Journal of Experimental Nephrology · doi:10.46439/nephrology.6.021
Yüzkat, N. (2026) · Anadolu Kliniği Tıp Bilimleri Dergisi · doi:10.21673/anadoluklin.2011817
Tursunovna, B. G., Baibusunova, A., Boshanova, A., Shegenov, G., Anapina, B., Biktashev, D., Jaxalykova, K. K., Turgumbaeva, A. B., Baubekova, A., Akylzhanova, Z., et al. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15197565
Federspiel, J. J., Berkowitz, C. M., & Lim, G. (2026) · Journal of Thrombosis and Haemostasis · doi:10.1016/j.jtha.2026.07.025
Usual Laboratory Exams in Women with Hypertension During Pregnancy
KORROU, G.-E., & Thomopoulos, C. (2026) · Updates in hypertension and cardiovascular protection · doi:10.1007/978-3-032-32879-3_6
Metadata
- Authors
- Erez, O., Novack, L., Beer-Weisel, R., Dukler, D., Press, F., Zlotnik, A., Than, N. G., Tomer, A., & Mazor, M.
- Affiliations
- Ben-Gurion University of the Negev (IL)
- Corresponding author
- Erez, Offer
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-04-11
- Volume
- 9
- Issue
- 4
- Pages
- e93240
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3984105
- OpenAlex
- W1975061570
- Cited by
- 146
- References
- 92
- Citations by year
- 2026: 16 · 2025: 14 · 2024: 20 · 2023: 11 · 2022: 19 · 2021: 12 · 2020: 19 · 2019: 7 · 2018: 9 · 2017: 7 · 2016: 7 · 2015: 3 · 2014: 1
- FWCI
- 4.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Keywords
- disseminated intravascular coagulation, pregnancy, fibrinogen, platelet count, prothrombin time, activated partial thromboplastin time, D-dimer
- MeSH terms
- Disseminated Intravascular Coagulation, Female, Fibrinogen, Hemostasis, Humans, Pregnancy, Prothrombin Time, Retrospective Studies, Thrombosis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
