The Efficacy of Antenatal Maternal Hemogram and Coagulation Test Parameters in Predicting Atony-Related Postpartum Hemorrhage

Abstract

This study aims to evaluate the efficacy of maternal hemogram parameters in PPH in term pregnancies. A retrospective analysis was conducted on 84 patients with atony-related PPH and 96 control patients with healthy deliveries, who presented to the Gynecology and Obstetrics Clinic of Samsun Education and Research Hospital between January 1, 2008, and December 31, 2023. Patients' data were retrieved from the hospital's information system. Exclusion criteria included pregnant women under 18 years, those with preeclampsia, chronic hypertension, or bleeding disorders. Evaluated parameters included age, BMI, gravida, parity, gestational age, mode of delivery, prepartum and postpartum hemogram and coagulation parameters, and neonatal outcomes. The mean age was 32.1±6.9 years in the PPH group and 30.1±5.8 years in the control group. Hemoglobin and hematocrit levels were significantly lower in the PPH group (Hb: 9.4±1.0 ng/ml) compared to the control group (Hb: 11.5±1.4 ng/ml, p<0.001). Plasma fibrinogen levels were also significantly lower in the PPH group (392.6±69.2 mg/dl) compared to the control group (467.2±69.6 mg/dl, p<0.001). A significant positive correlation was observed between plasma fibrinogen levels and 1- and 5-minute Apgar scores (p=0.002 and p<0.0001, respectively). BMI ≥28.8 was associated with a higher risk of hemorrhage. Maternal hemogram parameters, particularly hemoglobin, hematocrit, and fibrinogen levels, are effective predictors of postpartum hemorrhage. The study emphasizes the importance of monitoring these parameters to identify and manage at-risk pregnancies, thereby reducing maternal morbidity and mortality associated with PPH. © 2024 Ondokuz Mayis Universitesi. All rights reserved.