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

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.