Abstract
Since July 2023, 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. 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. We analyzed 212 women with singleton pregnancies who delivered after 22 gestational weeks and experienced blood loss ≥ 1,000 mL during vaginal delivery or ≥ 2,000 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 (92% vs 4%, p < 0.0001), as was the frequency of scores ≥ 8 according to the previous Japanese criteria (100% vs. 9%, p < 0.0001). The relationship between the overall scores using the new criteria with those using the previous criteria was significantly positive (p < 0.0001). Cronbach alpha was 0.767 and Pearson product-moment correlation coefficient was 0.712 between the new and previous criteria. In conclusion, we proved the effectiveness, reliability, and validity of the Japanese new criteria.