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The decrease of fibrinogen is an early predictor of the severity of postpartum hemorrhage
B Charbit1, L Mandelbrot, E Samain
1AP-HP, Hôpital Saint-Antoine, Clinical Investigation Center, Paris, France.
Journal of Thrombosis and Haemostasis : JTH
|November 8, 2006
Summary
A simple fibrinogen measurement can predict severe postpartum hemorrhage (PPH) risk. Lower fibrinogen levels at any time point indicate a higher likelihood of severe bleeding in PPH patients.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Maternal Health
Background:
- Postpartum hemorrhage (PPH) is a significant cause of maternal morbidity worldwide.
- Early identification of severe PPH cases is crucial for timely intervention and improved outcomes.
Purpose of the Study:
- To investigate the predictive value of hemostasis markers for PPH severity.
- To determine if changes in coagulation parameters correlate with the degree of postpartum bleeding.
Main Methods:
- 128 women with PPH were enrolled, with severe PPH defined by 24-hour outcomes.
- Serial coagulation tests (fibrinogen, factor V, PT, D-dimer, TAT, etc.) were performed at multiple time points (H0, H1, H2, H4, H24).
- Multivariate analysis was used to identify significant predictors of severe PPH.
Main Results:
- Women with severe PPH exhibited lower fibrinogen, factor V, antithrombin, and protein C levels, alongside prolonged prothrombin time and elevated D-dimer and TAT complexes compared to non-severe cases.
- Fibrinogen levels were the sole marker significantly associated with severe PPH from H0 to H4.
- A fibrinogen level
Conclusions:
- Fibrinogen level is a reliable and simple marker for anticipating the risk of severe postpartum hemorrhage.
- Early fibrinogen measurement can aid clinicians in risk stratification and management of PPH.
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