Fibrinogen as a potential diagnostic marker for prediction and evaluation of postpartum hemorrhage: a retrospective study

Figures & data

Figure 1. Flowchart.

Table 1. Patient characteristics (χ² test).

Variables items	FIB groups		p Value
	FIB < 4	FIB ≥ 4
Parity
Primiparous	27	46
Multiparous	28	27
History of ectopic pregnancy
Yes	4	1
No	51	72
Gestational diabetes
Yes	9	26	.016
No	46	47
Preeclampsia
Yes	5	6	1.000
No	50	67
Placenta previa
Yes	22	15	.016
No	33	58
Placental implantation
Yes	8	6	.256
No	47	67
Uterus scar
Yes	18	17	.236
No	37	56
Delivery
Cesarean	35	35	.092
Vaginal	20	37

Figure 2. The relationship between prenatal fibrinogen and the amount of blood loss (mL). (A) Scatter diagram of prenatal fibrinogen concentration and volume of blood loss. (B) Histogram of prenatal fibrinogen subsection and the mean value of blood loss.

Table 2. Prenatal laboratory examination.

Variable	FIB group	Cases	Mean value	SD	p Value
PT (s)	fib < 4	55	10.2745	1.33780	.180
	fib ≥ 4	73	10.0014	0.77253
INR	fib < 4	55	0.8815	0.14329	.429
	fib ≥ 4	73	0.8651	0.06147
APTT (s)	fib < 4	54	28.8944	5.29978	.122
	fib ≥ 4	73	27.5904	4.13981
TT (s)	fib < 4	54	14.6019	1.73515	<.001
	fib ≥ 4	73	13.0068	0.88386
D-dimer (μg/L)	fib < 4	54	17971.5274	116921.93	.290
	fib ≥ 4	72	957.8133	794.53450
WBC (×10^9/L)	fib < 4	53	9.9842	3.49773	.223
	fib ≥ 4	73	9.2823	2.91729
HGB (g/L)	fib < 4	53	110.7547	21.34596	.023
	fib ≥ 4	72	123.3472	35.25847
PLT (×10^9/L)	fib < 4	53	154.5094	55.13502	.035
	fib ≥ 4	73	174.2192	48.08131
ALB (U/L)	fib < 4	47	32.8021	9.54539	.362
	fib ≥ 4	63	34.4619	9.31995
TBIL (U/L)	fib < 4	39	10.31	7.056	.762
	fib ≥ 4	47	9.96	3.142
AST (U/L)	fib < 4	48	26.3229	28.30809	.182
	fib ≥ 4	63	35.3444	39.44215
ALT (U/L)	fib < 4	48	20.3771	20.84223	.076
	fib ≥ 4	63	32.1968	46.42327
LDH (U/L)	fib < 4	48	202.6812	79.41472	.287
	fib ≥ 4	63	186.3460	79.98615
GLU (mmol/L)	fib < 4	39	4.7146	1.01924	.296
	fib ≥ 4	57	5.0061	1.51266

Abbreviation: PT: prothrombin time; INR: international normalized ratio; APTT: activated partial thromboplastin time; TT: thrombin time; WBC: white blood cell count; HGB: hemoglobin; PLT: platelet count; ALB: albumin; TBIL: total bilirubin; AST: aspartate aminotransferase; ALT: alanine aminotransferase; LDH: lactate dehydrogenase; GLU: glucose.

Table 3. Multi-factor linear regression equation about the mean value of PPH and six major factors for PPH.

	Unstandardized coefficients		Standardized coefficients	t	Statistical significance	95.0% CI of B
	B	Standard error	Beta			Lower limit	Higher limit
(Constant)	7110.476	1387.873		5.123	<.001	4355.200	9865.753
Placenta Previa	−699.036	164.222	−0.344	−4.257	<.001	−1025.057	−373.015
Prenatal FIB	−307.219	82.394	−0.370	−3.729	<.001	−470.792	−143.646
Placental Abruption	−1519.180	411.309	−0.280	−3.694	<.001	−2335.732	−702.627
Prenatal INR	2146.563	684.005	0.257	3.138	.002	788.642	3504.484
Prenatal TT	−140.324	57.996	−0.240	−2.420	.017	−255.461	−25.187
Prenatal WBC	−48.389	21.428	−0.172	−2.258	.026	−90.928	−5.849

Figure 3. ROC curves of prenatal FIB for the degree of PPH. (A) Test variables: prenatal FIB; state variable: PPH or not; area under curve = 0.614 (p = .082); Standard error = 0.054; 95% CI = 0.507–0.721. (B) Test variable: prenatal FIB; state variable: severe PPH or not; area under curve = 0.613 (p = .027); standard error = 0.050; 95% CI = 0.516–0.710. (C) Test variable: prenatal FIB; state variable: refractory PPH or not; area under curve = 0.701 (p = .074); standard error = 0.107; 95% CI = 0.492–0.910.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the supplementary materials.