Reviewer ’s report  
 
Title: Successful conservative treatment for massive u terine bleeding with non -septic 
disseminated intravascular coagulation after termination of early pregnancy in a woman with 
huge adenomyosis: case report  
 
Version: 0 Date: 21 Nov 2019  
 
Reviewer: Jae Young Kwack  
 
Reviewer's report:  
 
This is very interesting case and it will be helpful when we met DIC patie nts with adenomyosis.  
 
However,There is a part that needs to be corrected to clarify the meaning.  
 
 
1. There's a question why she wanted to terminate the pregnancy although fetal heartbeat was 
intact.  
 
In the discussion, line 176 -177  "she was grateful that h er uterus was saved and wanted to get a 
child in the future. "  
 
Why the pregnancy should be terminated because she had medical problem or socio -economic 
problem? (Figure 1. seems to be that gestational sac is not in the proper location.)  
 
The reason must be mentioned because there could be legal problem in some other countries and 
social background should be understood about termination of pregnancy.  
 
 
2. Readers need more explanation of why you started to use "nafamostat mesylate" instead of 
choosing other a gents that have been proven to be effective to control DIC  
 
 
3. Please give an information of Reference values of each laboratory tests.  
 
Likewise Hb 7.5 (12 -14mg/dL) because laboratory test for DIC is not familiar with some readers.  
 
 
4. Conclusion in the a bstract can be misleading (line 49 -50)  
 
"Before Performing Hysterectomy" can be misunderstood that "when performing hysterectomy 
nafamostat mesylate can be used just before the procedure was ready."  
 
Please clarify the meaning of " It can be the other treat ment of choice instead of hysterectomy"  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quali ty of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1.  Have you in the past five years receiv ed reimbursements, f ees, funding, or salary 
from an organisation that may in any way gain or lose financial ly from the 
publication of this manuscript, either now or in the future?  
 
2.  Do you hold any stocks or shares in an organisation that may in any way g ain or 
lose financially from the publication of this manuscript, either now or in the 
future?  
 
3.  Do you hold or are you currently applying for any patents  relating to the content 
of the manuscript?  
 
4.  Have you received reimbursements, fees, funding, or sal ary from an organization 
that holds or has applied for patents relating to the content of the manuscript?  
 
5.  Do you have any other financial competing interests?  
 
6.  Do you have any non -financial competing interests in relation to this paper?  
 
If you can ans wer no to all of the above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
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