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The indicators for early blood transfusion in patients with placental abruption with intrauterine fetal death: a retrospective review
BACKGROUND: Placental abruption (PA) with intrauterine fetal death (IUFD) is associated with a high risk of postpartum hemorrhage (PPH) resulting from severe disseminated intravascular coagulation (DIC). Therefore, blood products that are sufficient for coagulation factor replacement must be prepare...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9670574/ https://www.ncbi.nlm.nih.gov/pubmed/36397012 http://dx.doi.org/10.1186/s12884-022-05187-9 |
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author | Sano, Yasuko Kasai, Michi Shinoda, Satoru Miyagi, Etsuko Aoki, Shigeru |
author_facet | Sano, Yasuko Kasai, Michi Shinoda, Satoru Miyagi, Etsuko Aoki, Shigeru |
author_sort | Sano, Yasuko |
collection | PubMed |
description | BACKGROUND: Placental abruption (PA) with intrauterine fetal death (IUFD) is associated with a high risk of postpartum hemorrhage (PPH) resulting from severe disseminated intravascular coagulation (DIC). Therefore, blood products that are sufficient for coagulation factor replacement must be prepared, and delivery should occur at referral medical institutions that are equipped with sufficient blood products and emergency transfusion protocols. We retrospectively reviewed the records of patients with PA and IUFD (PA-IUFD) to identify possible factors that may indicate the need for early blood transfusion and investigated whether the Japanese scoring system for PPH can be applied in such cases. METHODS: We used a database of 16,058 pregnant patients who delivered at Yokohama City University Medical Center between January 2000 and February 2016. Thirty-three patients were diagnosed with PA-IUFD before delivery and categorized into two groups–blood transfusion and non-transfusion–to compare the maternal characteristics and pregnancy outcomes. RESULTS: In patients with PA-IUFD, the transfusion group exhibited significantly more blood loss; lower fibrinogen levels and platelet counts; higher levels of fibrin degradation products (FDP), D-dimer, and prothrombin time; and a tendency for tachycardia on admission, compared to the non-transfusion group. Many patients in the transfusion group had normal fibrinogen levels on admission but later displayed markedly decreased fibrinogen levels. The Japan Society of Obstetrics and Gynecology (JSOG) DIC score was significantly higher in the transfusion than in the non-transfusion group. CONCLUSIONS: In PA-IUFD, the fibrinogen level, platelet count, D-dimer, FDP, heart rate, and JSOG DIC score on admission may indicate the need for blood transfusion. However, even with normal fibrinogen levels on admission, continuous monitoring is indispensable for identifying progressive fibrinogen reductions in patients with PA-IUFD. |
format | Online Article Text |
id | pubmed-9670574 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-96705742022-11-18 The indicators for early blood transfusion in patients with placental abruption with intrauterine fetal death: a retrospective review Sano, Yasuko Kasai, Michi Shinoda, Satoru Miyagi, Etsuko Aoki, Shigeru BMC Pregnancy Childbirth Research BACKGROUND: Placental abruption (PA) with intrauterine fetal death (IUFD) is associated with a high risk of postpartum hemorrhage (PPH) resulting from severe disseminated intravascular coagulation (DIC). Therefore, blood products that are sufficient for coagulation factor replacement must be prepared, and delivery should occur at referral medical institutions that are equipped with sufficient blood products and emergency transfusion protocols. We retrospectively reviewed the records of patients with PA and IUFD (PA-IUFD) to identify possible factors that may indicate the need for early blood transfusion and investigated whether the Japanese scoring system for PPH can be applied in such cases. METHODS: We used a database of 16,058 pregnant patients who delivered at Yokohama City University Medical Center between January 2000 and February 2016. Thirty-three patients were diagnosed with PA-IUFD before delivery and categorized into two groups–blood transfusion and non-transfusion–to compare the maternal characteristics and pregnancy outcomes. RESULTS: In patients with PA-IUFD, the transfusion group exhibited significantly more blood loss; lower fibrinogen levels and platelet counts; higher levels of fibrin degradation products (FDP), D-dimer, and prothrombin time; and a tendency for tachycardia on admission, compared to the non-transfusion group. Many patients in the transfusion group had normal fibrinogen levels on admission but later displayed markedly decreased fibrinogen levels. The Japan Society of Obstetrics and Gynecology (JSOG) DIC score was significantly higher in the transfusion than in the non-transfusion group. CONCLUSIONS: In PA-IUFD, the fibrinogen level, platelet count, D-dimer, FDP, heart rate, and JSOG DIC score on admission may indicate the need for blood transfusion. However, even with normal fibrinogen levels on admission, continuous monitoring is indispensable for identifying progressive fibrinogen reductions in patients with PA-IUFD. BioMed Central 2022-11-17 /pmc/articles/PMC9670574/ /pubmed/36397012 http://dx.doi.org/10.1186/s12884-022-05187-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Sano, Yasuko Kasai, Michi Shinoda, Satoru Miyagi, Etsuko Aoki, Shigeru The indicators for early blood transfusion in patients with placental abruption with intrauterine fetal death: a retrospective review |
title | The indicators for early blood transfusion in patients with placental abruption with intrauterine fetal death: a retrospective review |
title_full | The indicators for early blood transfusion in patients with placental abruption with intrauterine fetal death: a retrospective review |
title_fullStr | The indicators for early blood transfusion in patients with placental abruption with intrauterine fetal death: a retrospective review |
title_full_unstemmed | The indicators for early blood transfusion in patients with placental abruption with intrauterine fetal death: a retrospective review |
title_short | The indicators for early blood transfusion in patients with placental abruption with intrauterine fetal death: a retrospective review |
title_sort | indicators for early blood transfusion in patients with placental abruption with intrauterine fetal death: a retrospective review |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9670574/ https://www.ncbi.nlm.nih.gov/pubmed/36397012 http://dx.doi.org/10.1186/s12884-022-05187-9 |
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