title: Association between fibrinogen levels and severity of postpartum hemorrhage in singleton vaginal deliveries at a Japanese perinatal center.
abstract: OBJECTIVE
  We examined the relationship between low fibrinogen levels (<200 mg/dL) and the severity of postpartum hemorrhage in singleton vaginal deliveries after 22 weeks' gestation complicated by postpartum hemorrhage requiring transfusion at our hospital.
  
  
  RESULTS
  During a 10-year period, 61 women (0.38%) received transfusions owing to postpartum hemorrhage within the first 24 hours after delivery. Of these women, 13 (21%) had low fibrinogen levels (mean, 123 ± 68 mg/dL) when postpartum hemorrhage was diagnosed, and the other 48 (79%) had normal fibrinogen levels (mean, 305 ± 50 mg/dL). Neither total blood loss nor the incidence of additional therapies, such as hysterectomy, differed between the 2 groups of women. Women with low fibrinogen levels started to receive transfusions significantly earlier (98 ± 58 minutes after delivery) than did women with normal fibrinogen levels (142 ± 75 minutes after delivery, p=0.03) and received more units of fresh-frozen plasma (p=0.03).
  
  
  CONCLUSIONS
  The early transfusion of fresh-frozen plasma in women with postpartum hemorrhage and low fibrinogen levels might help prevent adverse outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital.
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Shibata
authors.forename: Daisuke
authors.initials: D
authors.lastname: Shigemi
authors.forename: Marie
authors.initials: M
authors.lastname: Ito
authors.forename: Kayoko
authors.initials: K
authors.lastname: Terada
authors.forename: Kazuho
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kato
authors.forename: Miwa
authors.initials: M
authors.lastname: Igarashi
authors.forename: Shunji
authors.initials: S
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D010949:Plasma; D006473:Postpartum Hemorrhage / Q000503:physiopathology*; D011247:Pregnancy; D012720:Severity of Illness Index
chemical_list: D005340:Fibrinogen