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A novel predictive marker for placental abruption with composite adverse outcomes: creatinine-fibrinogen ratio

Osman Onur Ozkavak1, Atakan Tanacan2,3, Murat Haksever2

  • 1Department of Perinatology, Ankara Bilkent City Hospital, Cankaya, 06800, Ankara, Turkey. onurozkavakdr@gmail.com.

Archives of Gynecology and Obstetrics
|January 25, 2024
PubMed

Insights

The creatinine-fibrinogen ratio (CFR) is a new, cost-effective marker for predicting adverse outcomes in placental abruption cases. This ratio offers a practical approach to identifying high-risk pregnancies.

Area of Science:

  • Obstetrics and Gynecology
  • Clinical Chemistry
  • Maternal-Fetal Medicine

Background:

  • Placental abruption poses significant risks to maternal and fetal health.
  • Predictive markers for adverse outcomes in placental abruption are crucial for timely intervention.
  • Existing markers may lack cost-effectiveness or broad applicability.

Purpose of the Study:

  • To develop and validate a novel, cost-effective marker, the creatinine-fibrinogen ratio (CFR).
  • To assess the predictive value of CFR for composite adverse outcomes (CAO) in patients with placental abruption.

Main Methods:

  • Retrospective cohort study of 109 placental abruption patients.
  • Inclusion criteria for CAO group: blood product transfusion, acute kidney injury, disseminated intravascular coagulation, or ICU admission.
  • Comparison of laboratory parameters and CFR values at hospital admission between CAO and non-CAO groups.

Main Results:

  • The CAO group exhibited higher creatinine and lower fibrinogen levels (p=0.007 and p<0.001, respectively).
  • The creatinine-fibrinogen ratio (CFR) was significantly higher in the CAO group (p<0.001).
  • ROC analysis showed an AUC of 0.802 for CFR in predicting CAO, with 77% sensitivity and 65% specificity.

Conclusions:

  • The creatinine-fibrinogen ratio (CFR) demonstrates significant potential as a predictive marker.
  • CFR is a practical and cost-effective tool for identifying pregnant women with ablatio placenta at risk of CAO.
  • This marker can aid in clinical decision-making and management of high-risk pregnancies.
Abstract

Keywords:
Creatinine–fibrinogen ratioPlacental abruption

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