title: Serum fibrinogen levels could be an index of successful use of balloon tamponade in postpartum hemorrhage.
abstract: OBJECTIVE
  The object of our study was to determine whether serum fibrinogen levels could be used to predict the success rates of balloon tamponade and decrease the use of invasive methods.
  
  
  METHODS
  This retrospective study, conducted at Rinku General Medical Center, was aimed to identify factors associated with high success rates in balloon tamponade. Forty-six patients with postpartum hemorrhage (PPH), non-responsive to uterotonics and treated with balloon tamponade between April 2008 and March 2015, were included.
  
  
  RESULTS
  Forty-six women were included, of which 34 underwent vaginal delivery and 12 underwent cesarean delivery. There were no complications from balloon tamponade and its success rate was 73.3%. Seven women required additional procedures: One used gauze packing, three used uterine artery embolization, and five underwent peripartum hysterectomy. The cut-off line of serum fibrinogen level was 172.5 mg/dL (P=0.002) with its 77.4% sensitivity and 66.7% specificity.
  
  
  CONCLUSIONS
  We recommend measuring serum fibrinogen level for predicting whether the balloon tamponade can be used successfully or not.
authors.affiliation: Department of Obstetrics and Gynecology, Rinku General Medical Center Senshu Regional Medical Center for Women and Children's Health, Izumisano-shi, Osaka, Japan.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Nakashima
authors.affiliation: Department of Obstetrics and Gynecology, Rinku General Medical Center Senshu Regional Medical Center for Women and Children's Health, Rinku Ourai Kita 2-23, Izumisano-shi, Osaka 598-8577, Japan, Phone: +81-72-469-3111, Fax: +81-72-469-7929.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Ogita
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Red Cross Hospital, Chuo-ku, Saitama-shi, Saitama, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Chita
authors.affiliation: Department of Obstetrics and Gynecology, Kaizuka City Hospital Senshu Regional Medical Center for Women and Children's Health, Kaizuka-shi, Osaka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yokoi
mesh_terms: D000328:Adult; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D006473:Postpartum Hemorrhage / Q000097:blood* / Q000628:therapy; D011247:Pregnancy; D012189:Retrospective Studies; D058738:Uterine Balloon Tamponade; D055815:Young Adult
chemical_list: D005340:Fibrinogen
keywords: Balloon tamponade; fibrinogen; postpartum hemorrhage