Evaluating the Significance of Coagulation Tests for the Preven-tion and Treatment of Disseminated Intravascular Coagulation: A Meta-Analysis

Lili  Chen; Yangyang Zhang; Qiqi  Ni

doi:10.18502/ijph.v54i11.20380

Lili Chen Department of Blood Transfusion, Wenzhou Central Hospital, Wenzhou City, Zhejiang Province, 325000, China
Yangyang Zhang Department of Blood Transfusion, Wenzhou Central Hospital, Wenzhou City, Zhejiang Province, 325000, China
Qiqi Ni Department of Laboratory, Wenzhou Central Hospital, Wenzhou City, Zhejiang Province, 325000, China

DOI: https://doi.org/10.18502/ijph.v54i11.20380

Keywords: Obstetrics; Disseminated intravascular coagulation; Coagulation test

Abstract

Background: We aimed to assess the clinical significance of obstetric coagulation tests in the prevention and treatment of disseminated intravascular coagulation (DIC) and to analyze the characteristics of changes in key coagulation indicators during pregnancy and delivery.

Methods: The system searched PubMed, Embase, Scopus, Web of science, Wanfang Data knowledge service platform, VIP and China Knowledge Network databases for relevant literature from inception to Aug 2024. Two researchers independently screened the literature, extracted the information and evaluated the risk of bias of the included studies. Statistical analysis was performed using Stata/SE 16.0 software.

Results: Twelve studies involving 2531 cases were included. Key findings versus non-pregnant women showed: significantly higher maternal D-dimer (Mean Difference (MD)=1.08, 95% Confidence Interval (CI): 0.61, 1.56) and fibrinogen (MD=1.57, 95%CI: 1.04, 2.10); and lower prothrombin time (PT) (MD=1.13, 95%CI: 0.43, 1.83) and activated partial thromboplastin time (APTT) (MD=0.73, 95%CI: 0.31, 1.16). Longitudinal trends across pregnancy trimesters were also significant: D-dimer increased from 0.24 mg/L to 0.46 mg/L and 0.72 mg/L (P=0.02); fibrinogen rose from 3.94 g/L to 4.38 g/L and 5.05 g/L (P<0.001); and PT demonstrated statistically significant changes (P=0.00).

Conclusion: Obstetric coagulation tests effectively reflect changing coagulation status during pregnancy, providing great value for early DIC prevention and intervention. Regular monitoring of key indices can help optimize clinical DIC management and offer more comprehensive strategies for obstetric patients.