Language：English   Publishing type：Research paper (scientific journal)  

AIM: 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. METHODS: This single-center retrospective cohort study included women who delivered at ≥ 22 weeks 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. RESULTS: 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-obstetric DIC group (55% vs. 24%; p = 0.002; relative risk, 2.27; 95% CI, 1.47-3.51). Fibrinogen levels were significantly lower in the severe group (163 mg/dL vs. 241 mg/dL, p < 0.001), whereas fibrin/fibrinogen degradation product (FDP) (85.6 μg/mL vs. 32.4 μg/mL, p = 0.61) and D-dimer (11.2 μg/mL vs. 9.5 μg/mL, p = 0.083) levels showed no significant differences. CONCLUSIONS: 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.

DOI： 10.1111/jog.70388

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

INTRODUCTION: Primary small bowel carcinoma in pregnant women is extremely rare. Small bowel cancer is difficult to diagnose because of its rarity, lack of specific clinical symptoms, and particular anatomical features. We experienced a case of primary small bowel adenocarcinoma with ovarian metastasis during pregnancy. This is the first reported case of a patient with small bowel adenocarcinoma whose pregnancy continued to term and ended in delivery. CASE PRESENTATION: A 32-year-old pregnant woman developed abdominal pain, and imaging examination revealed an ovarian tumor at 29 weeks of gestation. We performed laparotomy and resected the ovarian tumor, which was initially suspected to be primary ovarian cancer. The patient continued the pregnancy to term. A detailed examination of the abdominal cavity during cesarean delivery at 37 weeks revealed that the primary lesion was located in the small bowel. CONCLUSION: It is important to recognize that the small bowel may be the primary site of metastatic ovarian cancer. Detailed and careful examination is necessary to diagnose small bowel cancer during pregnancy.

DOI： 10.1159/000540524

PubMed

researchmap

Language：Japanese  

CiNii Research

researchmap

Other Link： https://search.jamas.or.jp/link/ui/2023286382