Association between fibrinogen levels and the severity of postpartum haemorrhage

  • Victoria García Velásquez Specialist in Obstetrics and Gynaecology, Critical Care Medicine and Intensive Care; Specialist at Women's ICU, Clínica del Prado, Medellín, Colombia
  • Marco González Agudelo Specialist in Internal Medicine, Critical Care Medicine and Intensive Care, Master in Epidemiology; Coordinator at Women's ICU, Clínica del Prado, Medellín, Colombia
  • Arturo Cardona Ospina Specialist in Obstetrics and Gynaecology, Fetal Medicine, Maternal-Fetal Unit Coordinator, Clínica del Prado, Medellín, Colombia
  • Ricardo Ardila Castellanos Specialist in Internal Medicine, Pulmonology, Epidemiology; Fellow in Critical Care Medicine and Intensive Care, UNAB, Colombia
Keywords: Postpartum hemorrhage, Fibrin fibrinogen degradation products, Blood transfusion, Blood coagulation, Maternal mortality

Abstract

Objective: To determine if the level of fibrinogen at the onset of postpartum haemorrhage is associated with bleeding severity and a higher number of complications; to determine outcome-related cut-off points.

Materials and methods: Secondary analysis of a cohort study conducted with 79 mothers admitted to the Intensive Care Unit between February 1st, 2012 and January 31st, 2013, with a diagnosis of postpartum haemorrhage, defined as all cases of blood loss greater than 1000 mL. Fibrinogen levels were measured at the onset of the postpartum haemorrhage. Fibrinogen values were compared between patients with severe obstetric bleeding and those with mild-to-moderate bleeding, in order to establish the correlation with severity of blood loss and complications.

Results: Overall, 24.1% of the patients showed severe postpartum haemorrhage compared to 75.9% of the patients classified as having mild-to-moderate haemorrhage. There were 12 complications (15.2%), including 9 cases of acute renal injury, 2 cases of disseminated intravascular coagulation, and one death, all of them only in patients with severe obstetric haemorrhage. Regarding the initial fibrinogen value, the AUC-ROC for fibrinogen levels and their relationship with the severity was 0.71, with a cut-off point of <200 mg/dL to predict severity (100% positive predictive value).

Conclusion: The initial fibrinogen level in obstetric postpartum haemorrhage is a predictor of severity that helps in alerting to the need for treatment in these patients.

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How to Cite
1.
García Velásquez V, González Agudelo M, Cardona Ospina A, Ardila Castellanos R. Association between fibrinogen levels and the severity of postpartum haemorrhage. Colomb. J. Anesthesiol. [Internet]. 2015 Apr. 1 [cited 2024 Feb. 28];43(2):136-41. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/439

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Published
2015-04-01
How to Cite
1.
García Velásquez V, González Agudelo M, Cardona Ospina A, Ardila Castellanos R. Association between fibrinogen levels and the severity of postpartum haemorrhage. Colomb. J. Anesthesiol. [Internet]. 2015 Apr. 1 [cited 2024 Feb. 28];43(2):136-41. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/439
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