{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T01:33:28Z","timestamp":1785288808126,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>In Japan, the diagnostic criteria for obstetric disseminated intravascular coagulation (DIC) were revised in 2024. This study aimed to evaluate the clinical utility of the revised obstetric DIC criteria, defined as the ability to identify patients at higher risk of severe maternal outcomes at presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010center retrospective cohort study included women who delivered at \u2265\u200922\u2009weeks of gestation and were transferred for primary postpartum hemorrhage (PPH) between April 2016 and March 2025. Women were compared according to obstetric DIC status and the presence of severe maternal outcomes to evaluate the ability of the revised criteria to identify patients with severe outcomes at presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among women transferred for primary PPH, 18% were diagnosed with obstetric DIC. Severe maternal outcomes occurred more frequently in the obstetric DIC group than in the non\u2010obstetric DIC group (55% vs. 24%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002; relative risk, 2.27; 95% CI, 1.47\u20133.51). Fibrinogen levels were significantly lower in the severe group (163\u2009mg\/dL vs. 241\u2009mg\/dL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), whereas fibrin\/fibrinogen degradation product (FDP) (85.6\u2009\u03bcg\/mL vs. 32.4\u2009\u03bcg\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.61) and D\u2010dimer (11.2\u2009\u03bcg\/mL vs. 9.5\u2009\u03bcg\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.083) levels showed no significant differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although the revised obstetric DIC criteria better reflect the underlying pathophysiology by incorporating hyperfibrinolysis, severe maternal outcomes were still observed in women without obstetric DIC, likely reflecting dilutional coagulopathy. These findings suggest that fibrinogen may serve as an indicator of maternal severity, complementing markers of enhanced fibrinolysis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70388","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T05:46:09Z","timestamp":1782884769000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Maternal Severity and Diagnostic Validity of the Revised Japanese Criteria for Obstetric Disseminated Intravascular Coagulation: A Retrospective Observational Study"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5521-7685","authenticated-orcid":false,"given":"Yutaro","family":"Takahashi","sequence":"first","affiliation":[{"name":"Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4107-0844","authenticated-orcid":false,"given":"Soichiro","family":"Obata","sequence":"additional","affiliation":[{"name":"Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayuri","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryosuke","family":"Shindo","sequence":"additional","affiliation":[{"name":"Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeru","family":"Aoki","sequence":"additional","affiliation":[{"name":"Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etsuko","family":"Miyagi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Yokohama City University Hospital  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(24)00560-6"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.16244"},{"key":"e_1_2_13_4_1","first-page":"119","article-title":"Obstetrical DIC Score","volume":"50","author":"Maki M.","year":"1985","journal-title":"Obstetrics and Gynecology Therapy"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12426"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.14875"},{"key":"e_1_2_13_7_1","first-page":"43","article-title":"Disseminated Intravascular Coagulation (DIC) in Obstetrics Field: Diagnostic Criteria for Obstetrical DIC (Tentative Version)","volume":"32","author":"Itakura A.","year":"2023","journal-title":"Japanese Journal of Obstetrics, Gynecology and Neonatal Hematology"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-68298-7"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-023-06095-2"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/2052-0492-2-20"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000202209.42491.38"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X0102900507"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.13788"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2011.01472.x"},{"key":"e_1_2_13_15_1","unstructured":"\u201cGuidelines for Perinatal Management and Response \u201d2022 https:\/\/www.jsog.or.jp\/activity\/pdf\/shusanki_taioushishin2022.pdf(in Japanese)."},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199508000-00026"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2007.02297.x"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2022.100778"}],"container-title":["Journal of Obstetrics and Gynaecology 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