Association of fibrinogen levels with severity of postpartum hemorrhage and contributing risk factors

Objective: To determine mean fibrinogen levels in postpartum hemorrhage and to compare mean fibrinogen levels in mild postpartum hemorrhage versus severe postpartum hemorrhage. Material and Methods: This Comparative cross-sectional study was conducted at the department of Gynecology in Holy Family Hospital, Rawalpindi with a duration of 06 months from January 2020 – June 2020. Sixty (60) postpartum hemorrhage patients aged 25-45 years were included. Hemorrhage caused by surgery like uterine rupture or wound of birth canal, coagulation disorders, and disseminated intravascular coagulation was excluded. Fibrinogen concentration was measured using Clauss assays with the help of an automated analyzer (Zonci xl1000s). Results were compared using an independent t-test. Result: The study included 60 patients with a mean age of 31.0 (4.7) years. The mean fibrinogen level among patients was 248.13 (72.9) mg/dl. In mild postpartum hemorrhage cases (32 patients), the mean fibrinogen level was 291.56 (69.8) mg/dl, while in severe cases (28 patients), it was 198.50 (35.2) mg/dl. The p-value of fibrinogen was 0.00, indicating a significant difference between the groups. No association was found between fibrinogen levels and age, parity, scar, or delivery mode (p-value > 0.05). Conclusion: This study concluded that mean fibrinogen levels in severe postpartum hemorrhage are less than 200mg/dl, as compared to the mean fibrinogen levels in mild postpartum hemorrhage which were greater than 25 0mg/dl and the difference is statistically significant. Keywords: Fibrinogen, Hemorrhage, Postpartum, Pregnancy, Severity.