Association of Plasma Fibrinogen Levels with Severity of Postpartum Hemorrhage: A Cross-Sectional Study: Fibrinogen Levels in Postpartum Hemorrhage

Arfa Zainab; Mona Kanwal Naz; Eshal Fawad; Ryan Fawad; Habiba Osaf; Syed Shah Qasim Hamdani

doi:10.54393/pjhs.v7i6.3979

Authors

Arfa Zainab Department of Obstetrics and Gynecology, Cantonment General Hospital, Rawalpindi, Pakistan
Mona Kanwal Naz Department of Obstetrics and Gynecology, Cantonment General Hospital, Rawalpindi, Pakistan
Eshal Fawad Department of Obstetrics and Gynecology, Cantonment General Hospital, Rawalpindi, Pakistan
Ryan Fawad Department of Obstetrics and Gynecology, Cantonment General Hospital, Rawalpindi, Pakistan
Habiba Osaf Department of Obstetrics and Gynecology, Cantonment General Hospital, Rawalpindi, Pakistan
Syed Shah Qasim Hamdani Department of Internal Medicine, Southern Illinois University, Springfield, Illinois, United States of America

DOI:

https://doi.org/10.54393/pjhs.v7i6.3979

Keywords:

Postpartum Hemorrhage, Fibrinogen, Hemostasis, Obstetric Bleeding

Abstract

Postpartum hemorrhage (PPH) significantly contributes to maternal morbidity and mortality worldwide. Identifying women at risk for severe PPH early is essential for timely intervention. Objective: To compare the mean plasma fibrinogen level between women with severe and non-severe postpartum hemorrhage (PPH). Methods: This comparative cross-sectional study was performed after its approval from the ethical committee with approval number Admin/PF/722A in the Department of Obstetrics and Gynecology at Cantt General Hospital, Rawalpindi, from July 3, 2025, to December 30, 2025. A total of 60 women with postpartum hemorrhage were enrolled using a consecutive sampling technique and categorized into non-severe PPH (n=30) and severe PPH (n=30) based on predefined clinical criteria. Plasma fibrinogen levels were assessed at the time of postpartum hemorrhage diagnosis with IBM SPSS version 25.0. A p-value of less than 0.05 was considered statistically significant. Results: Women experiencing severe PPH exhibited significantly lower fibrinogen levels in comparison to those with non-severe hemorrhage. The mean fibrinogen level in the non-severe postpartum hemorrhage group was 4.55±1.06 g/L, but in the severe PPH group it was 3.53±0.66 g/L, indicating a statistically significant difference (p=0.001). The findings demonstrate an inverse association between fibrinogen concentration and the severity of PPH, showing that lower fibrinogen levels are associated with an increased likelihood of severe bleeding. Conclusions: Reduced fibrinogen levels were significantly associated with severe PPH. Early measurement of fibrinogen may assist in identifying patients at increased risk of severe hemorrhage and ensure prompt management.

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