Hypofibrinogenemia and intrauterine fetal death

Abstract

The fibrinolytic system has been studied in 69 pregnancies involving intrauterine fetal death. In 29 of these fibrinogen levels were below the normal 200 mg. per cent. Among the group with hypofibrinogenemia 60 per cent had Rh-positive blood. Therefore, hypofibrinogenemia and severe bleeding can occur in the absence of Rh incompatibility and regardless of the cause of fetal death. In 4 cases the gestational age was 16 weeks or less and in 5 cases the retention of the dead fetus was 5 weeks or less. Therefore, in spite of the fact that in the majority of cases of hypofibrinogenemia the fetus had reached an age of more than 16 weeks and had been retained for longer than 5 weeks following death, these exceptions suggest that the fibrinogen level in all women with intrauterine fetal death should be determined.Fibrinogen was not administered prophylactically in any of the cases reported here and was used therapeutically to control excessive hemorrhage in only 4 cases.