Alhousseini et al reported a score for identifying a pregnant woman with non-overt disseminated intravascular coagulation (DIC). This may identify a woman who may experience postpartum hemorrhage. The authors are from NIH, Wayne State University, University of Michigan, Michigan State University and Manchester Royal Infirmary.
Patient selection: obstetrical patient without overt DIC
Parameters:
(1) plasma fibrinogen in mg/dL
(2) antithrombin activity as percent of normal
(3) protein C activity as percent of normal
(4) platelet count per microliter
(5) plasma D-dimer concentration in mg/L
(6) thrombin-antithrombin III in mg/L
Parameter
Finding
Points
fibrinogen
> 284 mg/dL
0
<= 284 mg/dL
1
antithrombin activity
> 88% of normal
0
<= 88% of normal
1
protein C activity
> 108% of normal
0
<= 108% of normal
1
platelet count
> 100,000 per µL
0
50,001 to 100,000
1
<= 50,000 per µL
2
D-dimer
< 2 mg/L
2 to 3.99 mg/L
1
>= 4.0 mg/L
2
thrombin-antithrombin III
< 19 mg/L
0
>= 19 mg/L
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• A score >= 3 indicates non-overt DIC.
Performance:
• The area under the ROC curve is 0.77.
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