The decrease of fibrinogen is an early predictor of the severity of postpartum hemorrhage
Open accessAbstract
Background Postpartum hemorrhage (PPH) is a major source of maternal morbidity.Objectives This study's objective was to determine whether changes in hemostasis markers during the course of PPH are predictive of its severity.Patients and methods We enrolled 128 women with PPH requiring uterotonic prostaglandin E2 (sulprostone) infusion. Two groups were defined (severe and non-severe PPH) according to the outcome during the first 24 hours. According to our criteria, 50 of the 128 women had severe PPH. Serial coagulation tests were performed at enrollment (H0), and 1, 2, 4 and 24 hours thereafter.Results At H0, and through H4, women with severe PPH had significantly lower fibrinogen, factor V, antithrombin activity, protein C antigen, prolonged prothrombin time, and higher D-dimer and TAT complexes than women with non-severe PPH. In multivariate analysis, from H0 to H4, fibrinogen was the only marker associated with the occurrence of severe PPH. At H0, the risk for severe PPH was 2.63-fold higher for each 1 gL(-1) decrease of fibrinogen. The negative predictive value of a fibrinogen concentration >4 gL(-1) was 79% and the positive predictive value of a concentration <or=2 gL(-1) was 100%.Conclusion These findings indicate that a simple fibrinogen measurement can anticipate the risk of severe bleeding in PPH.
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Early hypofibrinogenemia is highly predictive of severe postpartum hemorrhage.
“However, early hypofibrinogenemia is highly predictive of severe postpartum hemorrhage (100).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [100]
Cites
Disseminated Intravascular Coagulation
Levi, M. M., & Cate, H. T. (1999) · New England Journal of Medicine · doi:10.1056/nejm199908193410807 · Cited by 2,027 · see citing works
Haemostatic changes in pregnancy
Bremme, K. A. (2003) · Best Practice & Research Clinical Haematology · doi:10.1016/s1521-6926(03)00021-5 · Cited by 871 · see citing works
Waterstone, M., Murphy, J. D., Bewley, S., & Wolfe, C. D. A. (2001) · BMJ · doi:10.1136/bmj.322.7294.1089 · Cited by 774 · see citing works
Factors associated with postpartum hemorrhage with vaginal birth.
Combs, C. A., Murphy, E. L., & Laros, R. K. (1991) · PubMed · Cited by 622 · see citing works
Haemostatic changes in pregnancy
Brenner, B. (2004) · Thrombosis Research · doi:10.1016/j.thromres.2004.08.004 · Cited by 596 · see citing works
Pathogenesis of Disseminated Intravascular Coagulation in Sepsis
Levi, M. (1993) · JAMA · doi:10.1001/jama.1993.03510080079035 · Cited by 348 · see citing works
Fagon, J.-Y., Chastre, J. E., Novara, A., Médioni, P., & Gibert, C. (1993) · Intensive Care Medicine · doi:10.1007/bf01720528 · Cited by 310 · see citing works
Cerneca, F., Ricci, G., Simeone, R., Malisano, M., Alberico, S., & Guaschino, S. (1997) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/s0301-2115(97)02734-6 · Cited by 267 · see citing works
Duthie, S. J., Ven, D., Yung, G. L. K., Guang, D., Chan, S. Y. W., & Ma, H. (1991) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/0028-2243(91)90188-q · Cited by 198 · see citing works
Zhang, W., Alexander, S., Bouvier‐Colle, M., Macfarlane, A., & Bréart, G. (2004) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2004.00303.x · Cited by 192 · see citing works
Updates in the management of severe coagulopathy in trauma patients
Lynn, M., Jeroukhimov, I., Klein, Y., et al. (2002) · Intensive Care Medicine · doi:10.1007/s00134-002-1471-7 · Cited by 157 · see citing works
Successful reduction of massive postpartum haemorrhage by use of guidelines and staff education
Rizvi, F., Mackey, R., Barrett, T., et al. (2004) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2004.00103.x · Cited by 140 · see citing works
Evaluation of the quality of care for severe obstetrical haemorrhage in three French regions
Bouvier‐Colle, M., Joud, D. O. E., Varnoux, N., Goffinet, F., Alexander, S., Bayoumeu, F., Beaumont, E., Fernandez, H., Lansac, J., Lévy, G., et al. (2001) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2001.00224.x · Cited by 125 · see citing works
D‐dimer levels during delivery and the postpartum
Epiney, M., Boehlen, F., Boulvain, M., et al. (2005) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2004.01108.x · Cited by 123 · see citing works
Changes in hemostasis activity during delivery and theimmediate postpartum period
Gerbasi, F. R., Bottoms, S. F., Farag, A., et al. (1990) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(90)90006-s · Cited by 72 · see citing works
Simon, L., Santi, T. M., Sacquin, P., et al. (1997) · British Journal of Anaesthesia · doi:10.1093/bja/78.6.678 · Cited by 66 · see citing works
Diagnosis and Management of Acute Obstetrical DIC
Kobayashi, T., Terao, T., Maki, M., & Ikenoue, T. (2001) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-2001-14076 · Cited by 62 · see citing works
Montes, R., Páramo, J. A., Anglés‐Cano, E., & Rocha, E. A. V. (1996) · British Journal of Haematology · doi:10.1046/j.1365-2141.1996.416951.x · Cited by 47 · see citing works
The Fibrin Assay Comparison Trial (FACT): Correlation of Soluble Fibrin Assays with D-dimer
Zips, S., Ergül, H., Heene, D. L., et al. (2001) · Thrombosis and Haemostasis · doi:10.1055/s-0037-1616052 · Cited by 40 · see citing works
Massive post-partum haemorrhage and management of disseminated intravascular coagulation
Macphail, S., & Talks, K. (2004) · Current Obstetrics and Gynaecology · doi:10.1016/j.curobgyn.2003.12.004 · Cited by 39 · see citing works
Massive postpartum haemorrhage as a cause of maternal morbidity in a large tertiary hospital
Hazra, S., Chilaka, V. N., Rajendran, S., et al. (2004) · Journal of Obstetrics and Gynaecology · doi:10.1080/01443610410001722509 · Cited by 34 · see citing works
Thrombin-inhibitor complexes in the blood during and after delivery
Andersson, T. R., Lorentzen, B., Høgdahl, H., et al. (1996) · Thrombosis Research · doi:10.1016/0049-3848(96)00057-6 · Cited by 33 · see citing works
Alamia, V., & Meyer, B. A. (1999) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/s0889-8545(05)70081-4 · Cited by 29 · see citing works
[Severe post-partum hemorrhage: descriptive study at the Robert-Debré Hospital maternity ward].
Reyal, F., Deffarges, J. V., Luton, D., et al. (2002) · PubMed · Cited by 18 · see citing works
Trasylol in the management of abruptio placentae with consumption coagulopathy and uterine inertia.
Sher, G. (1980) · PubMed · Cited by 17 · see citing works
Langer, B., Boudier, É., Haberstich, R., et al. (2004) · PubMed · Cited by 17 · see citing works
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Cited by
Sorted by citations
Cahill, A. G., Beigi, R., Heine, R. P., Silver, R. M., & Wax, J. R. (2018) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2018.09.042 · Cited by 481 · see citing works
Wikkelsø, A. J., Edwards, H. M., Afshari, A., Stensballe, J., Langhoff-Roos, J., Albrechtsen, C., Ekelund, K., Hanke, G., Secher, E. L., Sharif, H. F., et al. (2015) · British Journal of Anaesthesia · doi:10.1093/bja/aeu444 · Cited by 267 · see citing works
Mallaiah, S., Barclay, P., Harrod, I., Chevannes, C., & Bhalla, A. (2015) · Anaesthesia · doi:10.1111/anae.12859 · Cited by 213 · see citing works
Thachil, J., & Toh, C.-H. (2009) · Blood Reviews · doi:10.1016/j.blre.2009.04.002 · Cited by 177 · see citing works
Erez, O., Mastrolia, S. A., & Thachil, J. (2015) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2015.03.054 · Cited by 170 · see citing works
McNamara, H., Kenyon, C., Smith, R., Mallaiah, S., & Barclay, P. (2019) · Anaesthesia · doi:10.1111/anae.14628 · Cited by 154 · see citing works
Ahmed, S., Harrity, C., Johnson, S., Varadkar, S., McMorrow, S., Fanning, R., Flynn, C. M., O' Riordan, J. M., & Byrne, B. M. (2012) · Transfusion Medicine · doi:10.1111/j.1365-3148.2012.01178.x · Cited by 118 · see citing works
Brandt, J. S., & Ananth, C. V. (2023) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.06.059 · Cited by 115 · see citing works
Major obstetric haemorrhage: monitoring with thromboelastography, laboratory analyses or both?
Karlsson, O., Jeppsson, A., & Hellgren, M. (2014) · International Journal of Obstetric Anesthesia · doi:10.1016/j.ijoa.2013.07.003 · Cited by 113 · see citing works
Rattray, D. D., O’Connell, C. M., & Baskett, T. F. (2012) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/s1701-2163(16)35214-8 · Cited by 104 · see citing works
Ducloy‐Bouthors, A., Mercier, F., Grouin, J., Bayoumeu, F., Corouge, J., Le Gouez, A., Rackelboom, T., Broisin, F., Vial, F., Luzi, A., et al. (2021) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.16699 · Cited by 88 · see citing works
Green, L., Knight, M., Seeney, F., Hopkinson, C., Collins, P. W., Collis, R. E., Simpson, N. A. B., Weeks, A., & Stanworth, S. J. (2016) · British Journal of Haematology · doi:10.1111/bjh.13864 · Cited by 77 · see citing works
Matsunaga, S., Takai, Y., Nakamura, E., Era, S., Ono, Y., Yamamoto, K., Maeda, H., & Seki, H. (2017) · Scientific Reports · doi:10.1038/srep46749 · Cited by 54 · see citing works
Platelet count and transfusion requirements during moderate or severe postpartum haemorrhage
Jones, R. M., de Lloyd, L., Kealaher, E. J., Lilley, G. J., Precious, E., Burckett st Laurent, D., Hamlyn, V., Collis, R. E., Collins, P. W., & collaborators (2016) · Anaesthesia · doi:10.1111/anae.13448 · Cited by 39 · see citing works
Seto, S., Itakura, A., Okagaki, R., Suzuki, M., & Ishihara, O. (2017) · International Journal of Obstetric Anesthesia · doi:10.1016/j.ijoa.2017.03.005 · Cited by 35 · see citing works
- Authors
- CHARBIT, B., MANDELBROT, L., SAMAIN, E., BARON, G., HADDAOUI, B., KEITA, H., SIBONY, O., MAHIEU‐CAPUTO, D., HURTAUD‐ROUX, M. F., HUISSE, M. G., DENNINGER, M. H., & DE PROST, D.
- Affiliations
- Hôpital Beaujon (FR)
- Hôpital Louis-Mourier (FR)
- Centre Hospitalier Universitaire de Besançon (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Venue
- Journal of Thrombosis and Haemostasis
- Publisher
- Elsevier BV
- Published
- 2007-02
- Volume
- 5
- Issue
- 2
- Pages
- 266-273
- ISSN
- 1538-7836 (ISSN-L)
- OpenAlex
- W1993947427
- Cited by
- 762
- References
- 26
- Citations by year
- 2026: 49 · 2025: 30 · 2024: 42 · 2023: 40 · 2022: 50 · 2021: 40 · 2020: 33 · 2019: 49 · 2018: 42 · 2017: 45 · 2016: 57 · 2015: 46 · 2014: 51 · 2013: 43 · 2012: 43
- FWCI
- 20.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thrombosis and Haemostasis (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Biochemistry › Blood transfusion and management
- Keywords
- postpartum hemorrhage, fibrinogen, hemostasis markers, severity prediction, coagulation tests, D-dimer, thrombin-antithrombin complex, factor V, antithrombin III, protein C, prothrombin time, sulprostone, maternal morbidity
- MeSH terms
- Adult, Blood Coagulation Tests, Female, Fibrinogen, Postpartum Hemorrhage, Humans, Predictive Value of Tests, Pregnancy, Severity of Illness Index, Time Factors, Dinoprostone, Biomarkers, Treatment Outcome
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