Experience with a blood fibrinogen bank

Abstract

An analysis of the first 76 obstetrical patients who received fibrinogen from the bank established in Philadelphia shows that there were 67 recoveries and 9 deaths. The fibrinogen was a decisive factor in the recovery of these patients with serious obstetrical hemorrhage.There is a close relationship between precipitate labor, abruptio placentae, postpartum hemorrhage, and fibrinogenopenia. The extremely large proportion of multiparas suggests that there may be a relationship between multiparity and precipitate labor that predisposes to this disease.Fibrinogen, as produced for the American Red Cross, is a relatively safe product as the incidence of hepatitis was only 3 cases, or 5 per cent. A supply of 10 Gm. of fibrinogen should be enough to meet the demands of any case that may develop. This supply might well be pooled by a community of several hospitals for reasons of economy.Analysis of the primary avoidable factors suggests that 9 cases were due to the elective use of Pitocin, either to induce or to stimulate labor without medical indication, and 3 cases to error in judgment or technique by the attending physician. This is a total of 12 cases, or 16 per cent, with 3 deaths. There were 9 cases attributed to the patient: 2 of induced abortion and death, and 7 with no prenatal care and recovery, making a total of 9 cases, or 12 per cent. In 51 cases, or 72 per cent, no avoidable factor was found.