TY - JOUR
T1 - Fibrin-based clot formation as an early and rapid biomarker for progression of postpartum hemorrhage: a prospective study
AU - Collins, Peter W.
AU - Lilley, Graeme
AU - Bruynseels, Daniel
AU - Burkett-St. Laurent, David
AU - Cannings-John, Rebecca
AU - Precious, Elizabeth
AU - Hamlyn, Vincent
AU - Sanders, Julia
AU - Alikhan, Raza
AU - Rayment, Rachel
AU - Rees, Alexandra
AU - Kaye, Abigail
AU - Hall, Judith E.
AU - Paranjothy, Shantini
AU - Weeks, Andrew
AU - Collis, Rachel E.
N1 - Acknowledgments
The authors thank the staff of the delivery suite at University Hospital of Wales for their many contributions to the study.
PY - 2014/9/11
Y1 - 2014/9/11
N2 - This prospective, observational study investigated the utility of Fibtem A5 and Clauss fibrinogen as predictors of progression of postpartum hemorrhage (PPH). A consecutive cohort of 356 women experiencing 1000 to 1500 mL PPH was recruited. Fibtem and fibrinogen were measured and subsequent transfusions, invasive procedures, and bleed volume recorded. Women progressing to 8 U blood products (red blood cells [RBCs] + fresh frozen plasma [FFP] + platelets) had a median (interquartile range) fibrinogen and Fibtem A5 of 2.1 (1.8-3.4) g/L and 12 (7-17) mm, respectively, compared with 3.9 (3.2-4.5) and 19 (17-23) for those not progressing. On multivariate analysis, Fibtem was an independent predictor for progression to bleeds >2500 mL (95% confidence interval [CI], 0.85 [0.77-0.95]). Receiver operating characteristic area under the curve (95% CI) for progression to RBC transfusion was 0.67 (0.60-0.74) for fibrinogen and 0.61 (0.54-0.68) for Fibtem, and progression to >2500 mL was 0.71 (0.61-0.81) and 0.75 (0.66-0.85) for fibrinogen and Fibtem, respectively. Fibtem A5
AB - This prospective, observational study investigated the utility of Fibtem A5 and Clauss fibrinogen as predictors of progression of postpartum hemorrhage (PPH). A consecutive cohort of 356 women experiencing 1000 to 1500 mL PPH was recruited. Fibtem and fibrinogen were measured and subsequent transfusions, invasive procedures, and bleed volume recorded. Women progressing to 8 U blood products (red blood cells [RBCs] + fresh frozen plasma [FFP] + platelets) had a median (interquartile range) fibrinogen and Fibtem A5 of 2.1 (1.8-3.4) g/L and 12 (7-17) mm, respectively, compared with 3.9 (3.2-4.5) and 19 (17-23) for those not progressing. On multivariate analysis, Fibtem was an independent predictor for progression to bleeds >2500 mL (95% confidence interval [CI], 0.85 [0.77-0.95]). Receiver operating characteristic area under the curve (95% CI) for progression to RBC transfusion was 0.67 (0.60-0.74) for fibrinogen and 0.61 (0.54-0.68) for Fibtem, and progression to >2500 mL was 0.71 (0.61-0.81) and 0.75 (0.66-0.85) for fibrinogen and Fibtem, respectively. Fibtem A5
U2 - 10.1182/blood-2014-04-567891
DO - 10.1182/blood-2014-04-567891
M3 - Article
VL - 124
SP - 1727
EP - 1736
JO - Blood
JF - Blood
SN - 0006-4971
IS - 11
ER -