The clinical efficacy of fibrinogen concentrate in massive obstetric haemorrhage with hypofibrinogenaemia
Open accessAbstract
Massive obstetric haemorrhage remains a major cause of maternal death attributable to hypofibrinogenaemia. Transfusion of large volumes of fresh frozen plasma (FFP) is required to normalise fibrinogen levels. We compared the efficacy of FFP (F group) with that of FFP plus fibrinogen concentrate (F + F group) in massive obstetric haemorrhage. In this retrospective study, we compared the medical charts (2004-2016) of 137 patients with <150 mg/dl fibrinogen treated with F + F (n = 47; after August 2009) or F (n = 56; before August 2009). Although fibrinogen concentrate was only administered in severe cases, the FFP/red blood cell concentrate (RCC) ratio was significantly lower in the F + F group than in the F group. A sub-group analysis of cases requiring ≥18 RCC units showed that the F + F group received significantly less FFP than the F group (40.2 ± 19.6 versus 53.4 ± 18.5 units; P = 0.047) and showed significantly less pulmonary oedema (24.0% vs 57.1%; P < 0.05) in the absence of any significant differences in pre-transfusion coagulation, estimated blood loss, or RCC transfusion volume. Administration of fibrinogen concentrate increased the rate of fibrinogen supplementation five-fold and reduced FFP dosage, the FFP/RCC ratio, and the incidence of pulmonary oedema.
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Observational studies suggest that administration of fibrinogen concentrate may reduce blood loss in hemorrhage-associated hypofibrinogenemia associated with abruption.
“Observational studies suggest that administration of fibrinogen concentrate may result in reduced blood loss in hemorrhage associated hypofibrinogenemia associated with abruption (102, 103).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [102]
The Discussion suggests fibrinogen concentrate could minimise blood loss in early-stage placental abruption, supporting the claim’s tentative wording. But the Results report no significant difference in estimated blood loss for that subgroup; the paper does not show a measured reduction or extend the suggestion beyond early-stage cases. No page numbers are available in our copy. (LLM, conf=0.82)
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- Authors
- Matsunaga, S., Takai, Y., Nakamura, E., Era, S., Ono, Y., Yamamoto, K., Maeda, H., & Seki, H.
- Affiliations
- Saitama Medical Center, Saitama Medical University (JP)
- Corresponding author
- Matsunaga, Shigetaka
- Venue
- Scientific Reports
- Published
- 2017-04-24
- Volume
- 7
- Issue
- 1
- Pages
- 46749-46749
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC5402272
- OpenAlex
- W2609151975
- Cited by
- 54
- References
- 33
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 9 · 2023: 6 · 2022: 5 · 2021: 5 · 2020: 4 · 2019: 10 · 2018: 5 · 2017: 1
- FWCI
- 3.69
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Saitama Medical University
- Japan Society for the Promotion of Science (26462499)
- Topics
- Health Sciences › Medicine › Biochemistry › Blood transfusion and management
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Keywords
- fibrinogen concentrate, hypofibrinogenemia, fresh frozen plasma, packed red blood cells, pulmonary edema, maternal mortality, blood transfusion, fibrinogen supplementation
- MeSH terms
- Adult, Female, Fibrinogen, Hemorrhage, Humans, Pregnancy, Pregnancy Complications, Retrospective Studies, Treatment Outcome, Coagulation Protein Disorders, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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