›› 2013, Vol. 28 ›› Issue (6): 492-495.DOI: 10.3969/j.issn.1673-8640.2013.06.009

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The significance of coagulation and fibrinolysis related parameters in the third trimester for predicting the postpartum hemorrhage among low-risk pregnant women

  

  1. Shanghai Jiaotong University School of Medicine International Peace Maternity and Children Healthcare Hospital,Shanghai 200030,China
  • Received:2012-12-01 Revised:2013-02-26 Online:2013-06-30 Published:2013-06-11

Abstract: Objective To investigate the significance of coagulation and fibrinolysis related parameters in the third trimester for predicting the postpartum hemorrhage among low-risk pregnant women. ?Methods A total of 2 562 singleton uncomplicated primiparous women were enrolled,and their peripheral blood was taken during 32-33 gestational weeks. The platelet(PLT)count,hemoglobin(Hb),fibrinogen(Fbg)and D-dimer(D-D)levels were determined. These women were followed up till delivery. The 48 of 2 562 women developed postpartum hemorrhage,including 16 of 48 women had severe postpartum hemorrhage. ?Results The Fbg level in severe postpartum hemorrhage group[(4.3±1.2)g/L] was lower than that in the normal pregnant group[(4.8±0.8)g/L,P=0.007]. When the participants were divided into 2 groups(normal pregnant group and postpartum hemorrhage group),the postpartum hemorrhage group had higher D-D level than the normal pregnant group[(1.8±1.3)g/L and(1.3±0.9)g/L,P=0.001]. When the participants were divided into 3 groups(normal pregnant group,postpartum hemorrhage group and severe postpartum hemorrhage group),the D-D level in the severe postpartum hemorrhage group was the highest with statistical significance[(2.4±1.7)g/L and(1.5±0.8)g/L,P=0.000];[(2.4±1.7)g/L and(1.3±0.9)g/L,P=0.000]. The PLT count in severe postpartum hemorrhage group was less than that in normal pregnant group[(172.4±38.9)×109 and(197.8±50.9)×109,P=0.044). The Fbg level determined in the third trimester had significance to predict postpartum hemorrhage among low-risk pregnant women [odd ratio(OR)= 1.89,95% confidence interval(CI): 1.68-2.03]. The D-D level had the prediction significance(OR=2.09,95%CI: 1.78-2.30). The decreasing PLT count in the third trimester had no obvious prediction significance(OR=1.50,95%CI:0.68-1.93). ?Conclusions The D-D and Fbg levels in the third trimester could predict postpartum hemorrhage.

Key words: Postpartum hemorrhage, Severe postpartum hemorrhage, Platelet, Fibrinogen, D-dimer