Diagnostic value of fibrinogen combined with thromboelastogram in postpartum hemorrhage after vaginal delivery

To investigate the diagnostic value of fibrinogen (Fib) combined with thromboelastogram (TEG) in postpartum hemorrhage (PPH) after vaginal delivery.

A total of 120 women who underwent vaginal delivery in our hospital were divided into a PPH group (n=50) and a non-PPH group (n=70). The reaction time (R), clotting time (K), Fib, and D-dimer (D-D) levels were compared between the two groups. Patients in the PPH group were sub-divided into a mild hemorrhage group (n=28) and a severe hemorrhage group (n=22). The receiver operator characteristic curves of R, K, Fib, and D-D for predicting PPH were plotted respectively.

The levels of R, K, and D-D in the PPH group were significantly higher than those in the non-PPH group. The Fib level was significantly lower than that in the non-PPH group (P<0.05). The severe hemorrhage group had significantly higher maternal R, K, and D-D levels and a significantly lower Fib level than the mild hemorrhage group (P<0.05). Correlation analysis showed that Fib was negatively correlated with R and K, and the D-D was positively correlated with R and K (P<0.05). The area under the curves of R, K, Fib, and D-D were 0.9690, 0.9917, 0.8512, and 0.8771, respectively (P<0.05).

Fib and TEG have good diagnostic values for PPH in women who underwent vaginal delivery, and can better predict PPH, providing evidence for clinical prevention and treatment of PPH.