ArticleBlood advances2018
Coagulation parameters during the course of severe postpartum hemorrhage: a nationwide retrospective cohort study.
Article in Blood advances, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 59 citations in OpenAlex.
- Efficacy of sonorheometry point of the care device in determining low fibrinogen levels in pregnant blood: an invitro dilution and reconstitution study.Journal of clinical monitoring and computing · 2022Trial
- Maternal Coagulation Profiles in Pregnant Women with Thalassemia: A Retrospective Observational Study in South China.International journal of women's health · 2026Article
- Pregnancy and postpartum dynamics revealed by millions of lab tests.Science advances · 2025Article
- Thromboelastography as an early prediction method for hypofibrinogenemia in emergency department patients with primary postpartum hemorrhage.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Observational
- Predictors and pathways of in-hospital mortality in active vascular contrast extravasation detected on abdominopelvic CT.Insights into imaging · 2024Article
- Hematologic characteristics and coagulopathy in pregnancy with COVID-19 succeeding the first wave: a multicenter retrospective cross-sectional study.Research and practice in thrombosis and haemostasis · 2024Article
- Trimester-specific reference intervals and profile of coagulation parameters for Chinese pregnant women with diverse demographics and obstetric history: a cross-sectional study.BMC pregnancy and childbirth · 2023Article
- Thrombomodulin (TM), thrombin-antithrombin complex (TAT), plasmin-α2-plasmininhibitor complex (PIC), and tissue plasminogen activator-inhibitor complex (t-PAIC) assessment of fibrinolytic activity in postpartum hemorrhage: a retrospective comparative cohort study.Annals of translational medicine · 2022Article
- Clinical value of early viscoelastometric point-of-care testing during postpartum hemorrhage for the prediction of severity of bleeding: A multicenter prospective cohort study in the Netherlands.Acta obstetricia et gynecologica Scandinavica · 2021Article
- Viscoelastic Hemostatic Assays for Postpartum Hemorrhage.Journal of clinical medicine · 2021Review
- Perioperative Cryoprecipitate Waste Reduction.Journal of medical systems · 2021Article
- Digital postpartum hemorrhage management device (DPHMD).BMC pregnancy and childbirth · 2019Article
- Association of Timing of Plasma Transfusion With Adverse Maternal Outcomes in Women With Persistent Postpartum Hemorrhage.JAMA network open · 2019Article
- Patient blood management in obstetrics: prevention and treatment of postpartum haemorrhage. A NATA consensus statement.Blood transfusion = Trasfusione del sangue · 2019Article
- Article
- Evaluating the Association Between Fibrinogen and Rotational Thromboelastometry and the Progression to Severe Obstetric Hemorrhage.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We describe the pattern of change in coagulation parameters during the course of severe postpartum hemorrhage in a retrospective cohort study among 1312 women experiencing severe postpartum hemorrhage necessitating blood transfusion. Levels of hemoglobin, hematocrit, platelet count, fibrinogen, activated partial thromboplastin time (aPTT) and prothrombin time (PT) per categorized volume of blood loss during severe postpartum hemorrhage were described and compared between women with and without the composite adverse outcome. Need for surgical intervention, severe acute maternal morbidity, and maternal mortality were jointly considered the composite adverse outcome. Of the 1312 women, 463 (35%) developed the composite adverse outcome. The incidence of a fibrinogen level <2 g/L was 26% (342 per 1312). Low fibrinogen and prolonged aPTT during the first 2 L of hemorrhage were associated with a subsequent composite adverse outcome; median fibrinogen and aPTT among women with and without the composite end point after 1.5 to 2 L of hemorrhage were 1.5 g/L (interquartile range [IQR], 1.0-1.9) vs 2.7 g/L (IQR, 1.9-3.4) and 39 s (IQR, 30-47) vs 32 s (IQR, 28-36), respectively. PT and platelet count as assessed during the first 2 L of hemorrhage were not associated with morbidity or mortality. Our results suggest that detection of low levels of fibrinogen and elevated aPTT levels during early postpartum hemorrhage can contribute to the identification of women that may benefit from targeted hemostatic treatment. Essential in this identification process is the moment of reaching a level of fibrinogen of <2 g/L during the course of postpartum hemorrhage.
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