Collins, Peter W.  ORCID: https://orcid.org/0000-0002-6410-1324, Lilley, Graeme, Bruynseels, Daniel, Burkett-St. Laurent, David, Cannings-John, Rebecca ORCID: https://orcid.org/0000-0001-5235-6517, Precious, Elizabeth, Hamlyn, Vincent, Sanders, Julia ORCID: https://orcid.org/0000-0001-5712-9989, Alikhan, Raza, Rayment, Rachel, Rees, Alexandra, Kaye, Abigail, Hall, Judith E. ORCID: https://orcid.org/0000-0002-6770-7372, Paranjothy, Shantini ORCID: https://orcid.org/0000-0002-0528-3121, Weeks, Andrew and Collis, Rachel E.
2014.
Fibrin-based clot formation as an early and rapid biomarker for progression of postpartum hemorrhage: a prospective study.
Blood
124
(11)
, pp. 1727-1736.
10.1182/blood-2014-04-567891
|
Abstract
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 <10 mm was associated with more prolonged bleeds (median [95% CI], 127 [44-210] compared with 65 [59-71] minutes; P = .018) and longer stay in the high-dependency unit (23.5 [18.4-28.5] compared with 10.8 [9.7-11.8] hours). Fibtem is a rapidly available early biomarker for progression of PPH.
| Item Type: | Article |
|---|---|
| Date Type: | Publication |
| Status: | Published |
| Schools: | Healthcare Sciences Medicine Systems Immunity Research Institute (SIURI) |
| Subjects: | R Medicine > R Medicine (General) R Medicine > RG Gynecology and obstetrics |
| Publisher: | American Society of Hematology |
| ISSN: | 0006-4971 |
| Date of Acceptance: | 29 June 2014 |
| Last Modified: | 13 Jan 2023 03:47 |
| URI: | https://orca.cardiff.ac.uk/id/eprint/78552 |
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