Analysis of Modified ISTH DIC Score in Cases of Abruptio Placentae and Its Correlation with Severity of Abruptio Placentae

Disseminated intravascular coagulation (DIC) is a potentially fatal condition which is always secondary to an underlying disorder with abruption being the most common cause in obstetrics.

Our study analysed the modified International Society of Thrombosis and Haemostasis DIC score for prediction of DIC in cases of abruptio placentae. Additionally, we correlated the score with severity of abruption to optimize its use in limited resource settings.

This was a prospective observational study of 126 participants admitted in Netaji Subhash Chandra Bose Medical College and Hospital, with the diagnosis of Abruptio Placentae and period of gestation more than 28 weeks. Modified ISTH DIC score calculated. A value > 26 suggested high probability of DIC. Resultant score of each participant was correlated with degree of abruption adapted from Page classification of severity of placental abruption.

In present study, 47 participants (37.3%) with abruptio placentae had high probability of DIC and all of them needed blood/blood product transfusion. Out of these 47 participants, 38 participants (80.85%) had Grade 3 abruption;while 9 participants(19.15%) had Grade 2 abruption. Association between grade of abruption and modified ISTH DIC score was found to be statistically significant (p value 0.001).

Anticipation and early prediction of disseminated intravascular coagulation is crucial for timely management of participants at risk. Present prospective study concludes that Modified ISTH DIC Score should be used for early prediction of DIC in cases of abruptio placentae; especially in cases with Grade 2 and Grade 3 abruption; to reduce overall maternal morbidity and mortality.