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.
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“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]
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“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]
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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].”
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Research works printed but not linked: 1
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Cited by
Sorted by citations
Disseminated intravascular coagulation: epidemiology, biomarkers, and management
Adelborg, K., Larsen, J. B., & Hvas, A. (2021) · British Journal of Haematology · doi:10.1111/bjh.17172 · Cited by 190
Erez, O., Mastrolia, S. A., & Thachil, J. (2015) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2015.03.054 · Cited by 170
DIC in Pregnancy – Pathophysiology, Clinical Characteristics, Diagnostic Scores, and Treatments
Erez, O., Othman, M., Rabinovich, A., Leron, E., Gotsch, F., & Thachil, J. V. (2022) · Journal of Blood Medicine · doi:10.2147/jbm.s273047 · Cited by 124
Brandt, J. S., & Ananth, C. V. (2023) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.06.059 · Cited by 115
Servante, J., Swallow, G., Thornton, J., Myers, B., Munireddy, S., Malinowski, A. K., Othman, M., Li, W., O’Donoghue, K., & Walker, K. F. (2021) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-021-03568-0 · Cited by 111
“scoring system has shown a sensitivity of 88% and a specificity of 96% for the diagnosis of DIC in pregnancy [4].”
BackgroundMethodInfluential
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
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