-Report on Experiments and Clinical Cases-

Association between Fibrinogen Levels and Severity of Postpartum Hemorrhage in Singleton Vaginal Deliveries at a Japanese Perinatal Center

Yoshie Shibata, Daisuke Shigemi, Marie Ito, Kayoko Terada, Kazuho Nakanishi, Masahiko Kato, Miwa Igarashi and Shunji Suzuki

Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital

Objective and Methods: 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).
Conclusion: The early transfusion of fresh-frozen plasma in women with postpartum hemorrhage and low fibrinogen levels might help prevent adverse outcomes.

J Nippon Med Sch 2014; 81: 94-96

Keywords
postpartum hemorrhage, fibrinogen level, singleton vaginal delivery, fresh-frozen plasma

Correspondence to
Shunji Suzuki, MD, Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, 5-11-12 Tateishi, Katsushika-ku, Tokyo 124-0012, Japan
czg83542@mopera.ne.jp

Received, October 31, 2013
Accepted, November 25, 2013