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Updated: Mar 27, 2026
The 4-vessel Sampling Approach to Integrative Studies of Human Placental Physiology In Vivo
Published on: August 2, 2017
Higher D-dimer level in the early third trimester predicts the occurrence of postpartum hemorrhage
Aims:
This study aimed to determine effective predictive factors for primary postpartum hemorrhage (PPH) among clinical blood parameters associated with coagulation and fibrinolysis and demographic characteristics.
Methods:
We retrospectively studied 1032 women who underwent determinations of clinical blood parameters at gestational week (GW) 29-32 and GW 35-37 and gave birth to singleton infants at our hospital between January 2011 and December 2013. PPH was defined as estimated blood loss ≥700 mL. Multivariate logistic regression analyses were used to determine independent risk factors and odds ratios (OR) for PPH.
Results:
PPH occurred in 104 of 1032 women (10%). Three blood variables, fibrinogen level <4.0 g/L (OR [95% CI], 1.96 [1.18-3.27]), antithrombin activity <85% of normal activity level (1.84 [1.05-3.21]), and D-dimer level >2.7 μg/mL (2.03 [1.29-3.19]) at GW 35-37, and three demographic characteristics, maternal age ≥35 years (1.75 [1.15-2.68]), BMI >28.2 kg/m2 on admission for childbirth (1.95 [1.20-3.16]), and previous cesarean delivery (2.77 [1.31-5.83]), were identified as independent risk factors for PPH.
Conclusion:
Among blood parameters, higher D-dimer levels and lower levels of antithrombin activity and fibrinogen in late gestation were independent risk factors for PPH.
