纤维蛋白原测定对产后出血量的预测意义

The Significance of Fibrinogen in Predicting Postpartum Hemorrhage

目的探讨孕晚期纤维蛋白原的检测对低危孕产妇产后出血量的预测意义。方法740例单胎足月初产妇,分娩方式为自然分娩或择期剖宫产,在分娩前3天内抽取外周血检测孕妇血常规、凝血功能,分娩后24小时检测孕产妇的血常规。根据孕产妇凝血功能中纤维蛋白原的结果分为4组,根据孕产妇的分娩前后血红蛋白下降计算产妇出血量,比较各组的出血量差异。结果我院孕产妇分娩前纤维蛋白原为2.6~5.1 g/L,平均(3.9±0.4)g/L,中位数3.95 g/L。当产妇分娩前纤维蛋白原在3~4 g/L时,产妇的产后出血量明显多于分娩前纤维蛋白原大于4g/L的产妇,差异有统计学意义(P<0.05)。当产妇分娩前纤维蛋白原小于3 g/L时,产妇的产后出血量与分娩前纤维蛋白原大于4 g/L的产妇差异无统计学意义(P>0.05)。结论孕晚期测定纤维蛋白原对孕产妇产后出血量有一定的预测意义。

Objective To investigate the significance of fibrinogen in late pregnancy in predicting postpartum hemorrhage in low—risk pregnant women.Methods 760 singleton uncomplicated primiparous women were enrolled,who were delivered by natural delivery or selective cesarean section.Their peripheral blood was collected within 3 days before delivery to test blood routine and coagulation function,24 hours after delivery their blood was collected to test blood routine.They were divided into 4 groups according to the result of fibrinogen.We calculated the amount of bleeding by the decline of hemoglobin,and compared the 4 groups’bleeding amount.Results The concentration of fibrinogen of our hospital was 2.6~5.1 g/L,average(3.9±0.4)g/L,median 3.95 g/L.The group of fibrinogen between 3~4 g/L had obviously more blood loss than the group of fibrinogen more than 4 g/L,the difference had statistical significance(P<0.05).The blood loss in group of fibrinogen less than 3 g/L and group of fibrinogen greater than 4 g/L had no statistical difference(P>0.05).Conclusions The fibrinogen levels in late pregnancy has certain significance in predicting postpartum hemorrhage.