Serum Fibrinogen as Adetection of Severity of Postpartum Hemorrhage

Abstract

Background: postpartum bleeding or postpartum hemorrhage (PPH) is often defined as the loss of more than 500 ml or 1,000 ml of blood within the first 24 hours following childbirth. The most common cause is poor contraction of the uterus following childbirth. However, the placenta being delivered, a tear of the uterus or poor blood clotting are other possible causes. Objective: the aim of the present work was to study the role of serum fibrinogen as a predictor for the severity of postpartum hemorrhage. Patients and Methods: this prospective multicenter study was conducted from February 2017 to October 2017 at Department of Obstetrics and Gynecology, Sayd Galal Hospital, Al-Azhar University. Results: PPH was severe for 43 of the 100 (43%) women included, but not for 75 (57%). Among the women with severe haeb hemorrhage, no women required embolization, 12 ligation of the uterine arteries, and 7 hysterectomy; 7 were transferred to intensive care, 37 received transfusions, and 42 had a postpartum hemoglobin level that decreased more than 4 g litre. None of the women died. Conclusion: the fibrinogen level at PPH diagnosis is a marker of the risk of aggravation and should serve as an alert to clinicians.