Criteria of Shirahata et al for Disseminated Intravascular Coagulation (DIC) in a Newborn Infant

 

Prerequisites:

(1) presence of one or more underlying diseases (see below)

(2) one or more of the following:

(2a) presence of bleeding

(2b) pH <= 7.2

(2c) PaO2 <= 40 mm Hg

(2d) rectal temperature <= 34°C

(2e) systolic blood pressure <= 40 mm Hg

 

Laboratory testing:

(1) platelet count

(2) plasma fibrinogen

(3) fibrin degradation products (FDP)

Laboratory Test	Finding	Points
platelet count	> 150,000 per µL	0
	100,001 to 150,000 per µL	1
	<= 100,000 per µL	2
fibrinogen	> 150 mg/dL	0
	101 - 150 mg/dL	1
	<= 100 mg/dL	2
fibrin degradation products	< 10 µg/mL (mg/L)	0
	10 - 39.9 µg/mL	1
	>= 40 µg/mL	2

 

total score for laboratory findings =

= SUM(points for all 3 tests)

 

Interpretation:

• minimum laboratory test score: 0

• maximum laboratory test score: 6

 

Score	DIC is
4, 5 or 6	definite
3	probable
2	possible
0 or 1	uncertain

 

Conditions associated with DIC in the newborn period include (Table 7, page 286):

(1) abruptio placentae

(2) pre-eclampsia or eclampisa

(3) dead twin fetus

(4) perinatal fetal distress

(5) amniotic fluid embolism

(6) difficult breech delivery

(7) respiratory distress syndrome

(8) massive aspiration syndrome

(9) recurrent apnea

(10) pneumonia

(11) massive pulmonary hemorrhage

(12) severe respiratory distress

(13) serious infection (bacterial, viral, syphilis, toxoplasmosis, etc.)

(14) erythroblastosis fetalis

(15) giant hemangioma

(16) renal vein thrombosis

(17) sclerema neonatorum

(18) necrotizing enterocolitis

(19) intracranial hemorrhage

(20) hyperviscocity