Correlations low fibrinogen plasma concentration before delivery with postpartum hemorrhage
YANG Weiwei1, SUN Xihong1, QIN Li1, WANG Manli1, CHEN Yan1, LI Yan2
1.Department of Obstetrics, Hebei Maternity and Child Health Care Hospital, Shijiazhuang 050051, China; 2.Beidaihe Sanatorinm of the Joint Logistics Support Force of the Chinese People’s Liberation Arm, Beidaihe 066100, China
Abstract：Objective To investigate the relationships between low concentrations of fibrinogen plasma before vaginal delivery and postpartum hemorrhage in order to provide evidence for predicting and preventing postpartum hemorrhage. Methods Four hundred and fifty pregnant women were selected randomly between January 2017 and February 2019 at the Department of Obstetrics of our hospital. 150 of them whose fibrinogen concentration was above 3 g/L were assigned to the low fibrinogen group, while the rest were randomly and equally divided into the low carboprost tromethamine group and high fibrinogen group. The low carboprost tromethamine group was given 250 μg carboprost tromethamine injection after delivery of the fetal shoulder,while the other two groups were injected with oxytocin. Postpartum hemorrhage was observed. Fibrinogen concentration was determined upon admission to the labor ward in each group of women and after the placenta was delivered. Results There were 15 cases of postpartum hemorrhage (10.0%) in the low fibrinogen group,8 cases (5.33%) in the low carboprost tromethamine group and 2 cases (1.33%) in the high fibrinogen group. There was statistically significant difference (P=0.005) in postpartum hemorrhage between the three groups. The low fibrinogen group had significantly less postpartum hemorrhage than the low fibrinogen group (399.00±158.10) ml vs (512.67±175.49) ml, compared with (281.00±10.39) ml in the high fibrinogen group. Conclusions Low levels of prenatal fibrinogen can increase the risk of postpartum hemorrhage, possibly because postnatal fibrinogen is significantly lower after delivery, so a low level of prenatal fibrinogen may be considered a predictive index for possible postpartum hemorrhage.
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2020, Vol. 31 
