Use of Fibrinogen in Prevention and Management of Postpartum Haemorrhage in High Risk Patient

Abstract

Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality, particularly in high-risk pregnant patients. The early prediction and effective management of PPH are crucial to improving maternal outcomes. Serum fibrinogen levels have emerged as a potential biomarker for predicting and managing PPH. This study aimed to study the role of serum fibrinogen level in prediction and anticipation of postpartum hemorrhage and its role in the treatment. Methods: This cross-sectional observational study was carried out on pregnant females at high risk of PPH attending Benha University Hospital and Toukh Central Hospital over a six-month period. Detailed clinical assessments, laboratory investigations, and obstetric monitoring were conducted. Serum fibrinogen levels were measured using quantitative analysis. Antenatal and intrapartum care were tailored to patient needs. PPH cases received treatment with fibrinogen concentrate, cryoprecipitate, or fresh frozen plasma as indicated. Results: According to serum fibrinogen levels, the mean serum fibrinogen levels of the studied cases was 3.6 (±1.15) g/l. There was high statistically significant relation between bleeding severity and serum fibrinogen. According to Roc curve analysis for the use of serum fibrinogen levels to predict severity of bleeding, using serum fibrinogen levels at 3.95, it can predict PPH with 0.859 AUC, sensitivity 100%, specificity 71.9%, PPV 66.7%, NPV 100% and accuracy 82.0%. Conclusion: Serum fibrinogen levels show promise as a valuable predictor for PPH in high-risk pregnant patients. Monitoring fibrinogen levels could aid in early identification and timely intervention, potentially reducing the severity and complications of PPH.