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The role of decreased fibrinogen percentage in prediction of severity of postpartum haemorrhage M. Signaroldi, F. Cirillo, P.Mustoni, G.Loi, T. Stampalija,

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Presentation on theme: "The role of decreased fibrinogen percentage in prediction of severity of postpartum haemorrhage M. Signaroldi, F. Cirillo, P.Mustoni, G.Loi, T. Stampalija,"— Presentation transcript:

1 The role of decreased fibrinogen percentage in prediction of severity of postpartum haemorrhage M. Signaroldi, F. Cirillo, P.Mustoni, G.Loi, T. Stampalija, E. Ferrazzi A.Ragusa Dept Obstet Gynecol, Buzzi Childrens Hospital, University Department of Clinical Sciences, University of Milan Global Congress of Maternal and Infant Health Barcelona 2010

2 Clinical retrospective study (delivery ward register 1/01/2009-31/08/2010) 5908 deliveries PPH 2000 ml 19 cases ( 3) 16 included 3 excluded Group A Patients with a major complication ( hysterectomy, haemostaic surgery, blood/plasma trasfusion..) 9 cases Group B Patients with minor complications ( medical treatment, curettage..) 7 cases Study design Global Congress of Maternal and Infant Health Barcelona 2010

3 Results (3) (comparison between group A and B with Mann-Whitney test) Group A Group BP value Fibrinogen before deliveryMedian4894880,9 Fibrinogen after delivery2323650,007 Time of bleeding (minutes)591830,09 Blood/Plasma TransfusionCases900,0009 Hysterectomy500,003 Intensive Unite Care500,003

4 grupp o CCp. e. cc riduzione %PROMEPHPLACENTARCUsulprPIUTRASF.ISTER.UTIALTRO A 4908250083Xno x XXUTIB-LYNCH A 5164420074no XXXX 7 EC, 3 PFCXUTI A 2517460062no N.I. ACCRETAXxXX 2plasmaXUTI A 9043350056no PPC ACCRETAno xXokno A 14500200052no PPC ACCRETAnox X 1emazienoOKno A 16601300050Xno X X X 3plasma, 2emazienoOK A 3916200048XXno XXUTI B-LYNCH, ematoma legamento largo, 2° LPT A 13220/1488 8210047no si noX 2emazienoUTI RCU, tamponamento, legatura uterine a 22gg A 11886250017no PPC ACCRETAno X 2plasma, 3emazienoOK PERDITA EMATICA MEDIA 2933,33 3343855 grupp o CCp. e. cc riduzione %PROMEPHPLACENTARCUsulprPIUTRASF.ISTER.UTIALTRO B 15282230043no OKno B 14554200034no x OKno B 1598210030X no X B 16003200027no x OKno B 13844200020no Xx OKno B 1368250018X no B 9660200013no X OKs. di Asherman PERDITA EMATICA MEDIA 2128,57 1240000

5 Conclusions 1 ) The prognosis and outcomes of PPH are more severe if fibrinogen percentage, before and after delivery, decreased is higher than 50%. 2) PPH pathogenesis Hypothesis First phase Hypovolemia Shock Second phase Endothelial damage DIC Fibrinogen Serial coagulation tests (every 1 hour) Thromboelastometry can guide the medical intervention 3) Clinical practice


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