The role of fibrinogen in postpartum hemorrhage

Authors: Vermeulen, T; van de Velde, M

Affiliations: Department of Anaesthesiology, UZ Leuven, Herestraat 49, 3000, Leuven, Belgium. Department of Anaesthesiology, UZ Leuven, Herestraat 49, 3000, Leuven, Belgium; Department of Cardiovascular Sciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium. Best practice & research.

Publication: Clinical anaesthesiology; 2022 ; 36. 399–410

Abstract: Postpartum hemorrhage (PPH) is the leading cause of maternal death worldwide (WHO), with almost 60000 deaths annually. Pregnancy is a prothrombotic state with increased levels of several coagulation factors to protect the parturient from bleeding problems during delivery. Fibrinogen has a significant role in coagulation and bleeding. Studies have pointed out that lower fibrinogen levels before delivery, but also at the initiation of PPH, are predictive of major hemorrhage. Early, the goal-directed fibrinogen concentrate therapy might be very useful in a subgroup of patients with serious PPH. This review aims to summarize the current literature on fibrinogen during PPH.