BACKGROUND: The aim of the study was to determine whether the fibrinogen level at diagnosis of postpartum haemorrhage (PPH) is associated with the severity of bleeding. METHODS: This is a secondary analysis of a population-based study in 106 French maternity units identifying cases of PPH prospectively. PPH was defined by a blood loss exceeding 500 ml during the 24 h after delivery or a peripartum haemoglobin decrease of more than 20 g litre(-1). This analysis includes 738 women with PPH after vaginal delivery. Fibrinogen levels were compared in patients whose PPH worsened and became severe and those whose PPH remained non-severe. Severe PPH was defined as haemorrhage by occurrence of one of the following events: peripartum haemoglobin decrease ≥ 40 g litre(-1), transfusion of concentrated red cells, arterial embolization or emergency surgery, admission to intensive care, or death. RESULTS: The mean fibrinogen concentration at diagnosis was 4.2 g litre(-1) [standard deviation (sd)=1.2 g litre(-1)] among the patients without worsening and 3.4 g litre(-1) (sd=0.9 g litre(-1)) (P<0.001) in the group whose PPH became severe. The fibrinogen level was associated with PPH severity independently of other factors [adjusted odds ratio=1.90 (1.16-3.09) for fibrinogen between 2 and 3 g litre(-1) and 11.99 (2.56-56.06) for fibrinogen <2 g litre(-1)]. CONCLUSIONS: The fibrinogen level at PPH diagnosis is a marker of the risk of aggravation and should serve as an alert to clinicians.
BACKGROUND: The aim of the study was to determine whether the fibrinogen level at diagnosis of postpartum haemorrhage (PPH) is associated with the severity of bleeding. METHODS: This is a secondary analysis of a population-based study in 106 French maternity units identifying cases of PPH prospectively. PPH was defined by a blood loss exceeding 500 ml during the 24 h after delivery or a peripartum haemoglobin decrease of more than 20 g litre(-1). This analysis includes 738 women with PPH after vaginal delivery. Fibrinogen levels were compared in patients whose PPH worsened and became severe and those whose PPH remained non-severe. Severe PPH was defined as haemorrhage by occurrence of one of the following events: peripartum haemoglobin decrease ≥ 40 g litre(-1), transfusion of concentrated red cells, arterial embolization or emergency surgery, admission to intensive care, or death. RESULTS: The mean fibrinogen concentration at diagnosis was 4.2 g litre(-1) [standard deviation (sd)=1.2 g litre(-1)] among the patients without worsening and 3.4 g litre(-1) (sd=0.9 g litre(-1)) (P<0.001) in the group whose PPH became severe. The fibrinogen level was associated with PPH severity independently of other factors [adjusted odds ratio=1.90 (1.16-3.09) for fibrinogen between 2 and 3 g litre(-1) and 11.99 (2.56-56.06) for fibrinogen <2 g litre(-1)]. CONCLUSIONS: The fibrinogen level at PPH diagnosis is a marker of the risk of aggravation and should serve as an alert to clinicians.
Authors: Ada Gillissen; Thomas van den Akker; Camila Caram-Deelder; Dacia D C A Henriquez; Kitty W M Bloemenkamp; Moniek P M de Maat; Jos J M van Roosmalen; Joost J Zwart; Jeroen Eikenboom; Johanna G van der Bom Journal: Blood Adv Date: 2018-10-09
Authors: D Schlembach; M G Mörtl; T Girard; W Arzt; E Beinder; C Brezinka; K Chalubinski; D Fries; W Gogarten; B-J Hackelöer; H Helmer; W Henrich; I Hösli; P Husslein; F Kainer; U Lang; G Pfanner; W Rath; E Schleussner; H Steiner; D Surbek; R Zimmermann Journal: Anaesthesist Date: 2014-03 Impact factor: 1.041
Authors: Catherine E Majors; Chelsey A Smith; Mary E Natoli; Kathryn A Kundrod; Rebecca Richards-Kortum Journal: Lab Chip Date: 2017-10-11 Impact factor: 6.799