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Higher D-dimer level in the early third trimester predicts the occurrence of postpartum hemorrhage

  • Naho Endo-Kawamura , Mana Obata-Yasuoka EMAIL logo , Hiroya Yagi , Rena Ohara , Yuko Nagai , Miyuki Mayumi , Kanako Abe and Hiromi Hamada
Published/Copyright: January 12, 2016
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 44 Issue 5

Abstract

Aims: This study aimed to determine effective predictive factors for primary postpartum hemorrhage (PPH) among clinical blood parameters associated with coagulation and fibrinolysis and demographic characteristics.

Methods: We retrospectively studied 1032 women who underwent determinations of clinical blood parameters at gestational week (GW) 29–32 and GW 35–37 and gave birth to singleton infants at our hospital between January 2011 and December 2013. PPH was defined as estimated blood loss ≥700 mL. Multivariate logistic regression analyses were used to determine independent risk factors and odds ratios (OR) for PPH.

Results: PPH occurred in 104 of 1032 women (10%). Three blood variables, fibrinogen level <4.0 g/L (OR [95% CI], 1.96 [1.18–3.27]), antithrombin activity <85% of normal activity level (1.84 [1.05–3.21]), and D-dimer level >2.7 μg/mL (2.03 [1.29–3.19]) at GW 35–37, and three demographic characteristics, maternal age ≥35 years (1.75 [1.15–2.68]), BMI >28.2 kg/m2 on admission for childbirth (1.95 [1.20–3.16]), and previous cesarean delivery (2.77 [1.31–5.83]), were identified as independent risk factors for PPH.

Conclusion: Among blood parameters, higher D-dimer levels and lower levels of antithrombin activity and fibrinogen in late gestation were independent risk factors for PPH.

Keywords: Antithrombin; d-dimer; fibrinogen; postpartum hemorrhage
Corresponding author: Mana Obata-Yasuoka, MD, PhD, Faculty of Medicine, Department of Obstetrics and Gynecology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan, Tel.: +81-29-853-3210, Fax: +81-29-853-3072, E-mail:

  1. Disclosure: We have no circumstances of conflict of interest that should be disclosed. We have not received any financial support regarding this study.

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  1. The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2015-8-14
Accepted: 2015-11-23
Published Online: 2016-1-12
Published in Print: 2016-7-1

©2016 by De Gruyter

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https://doi.org/10.1515/jpm-2015-0287
Keywords for this article
Antithrombin; d-dimer; fibrinogen; postpartum hemorrhage

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Preventing preterm birth
  4. Original articles
  5. Vertically transmitted cytomegalovirus infection in newborn preterm infants
  6. Computerized vital signs analysis and late onset infections in extremely low gestational age infants
  7. Oral propranolol in early stages of retinopathy of prematurity
  8. Changes in incidence of iatrogenic and spontaneous preterm births over time: a population-based study
  9. Predictive factors for preterm delivery under rural conditions in post-tsunami Banda Aceh
  10. Early pregnancy serum neopterin concentrations predict spontaneous preterm birth in asymptomatic pregnant women
  11. Funisitis is more common in cervical insufficiency than in preterm labor and preterm premature rupture of membranes
  12. Amniotic fluid LPCAT1 mRNA correlates with the lamellar body count
  13. Recommendation and Guidelines for Perinatal Practice
  14. Fetal magnetic resonance imaging and ultrasound
  15. Original articles - Obstetrics
  16. Relationship between first-trimester serum placental protein-13 and maternal characteristics, placental Doppler studies and pregnancy outcome
  17. Higher D-dimer level in the early third trimester predicts the occurrence of postpartum hemorrhage
  18. Extra-abdominal removal of placenta during cesarean section: a prospective randomized controlled trial of a novel technique
  19. Correlation of intrapartum translabial ultrasound parameters with computed tomographic 3D reconstruction of the female pelvis
  20. Cost effectiveness of universal umbilical cord blood gas and lactate analysis in a tertiary level maternity unit
  21. Original articles - Fetus
  22. Is there a sex difference in fetal behavior? A comparison of the KANET test between male and female fetuses
  23. Determination of antepartum and intrapartum risk factors associated with neonatal intensive care unit admission
  24. Short communication
  25. A guide on how to build a novel home-made part task training simulator for cervical cerclage training
  26. Congress Calendar
  27. Congress Calendar
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