Validación del fibrinógeno como predictor de severidad en puérperas atendidas con hemorragia posparto. Hospital Vicente Corral Moscoso, Cuenca – 2020

Abstract

Background: the decrease in fibrinogen levels is greater in patients with severe postpartum hemorrhage (PPH); the measurement of fibrinogen can be a parameter that predicts severe bleeding. Objective: to validate fibrinogen as a predictor of the severity of PPH in patients at the Vicente Corral Moscoso Hospital. Basin – 2020. Methodology: observational study, diagnostic test validation. It included 198 participants with PPH. The independent variable is fibrinogen, the dependent variables are the severity of bleeding and complications. Sensitivity, specificity, PPV, NPV and ROC curve were evaluated. All bioethical procedures were applied. Results: The prevalence of severe PPH was 31.8%. Median fibrinogen was 258mg/dl in the severe bleeding group and 359mg/dl in the non-severe bleeding group (p=0.000). The median fibrinogen in the group with complications was 219 mg/dl compared to the group without complications of 358 mg/dl (p=0.000). The cut-off point to predict severe PPH was a fibrinogen level of 290mg/dl (S=68.3%, E=79.3%, PPV=60.6% and NPV=84.3%) and to predict complications associated with PPH, the fibrinogen value was 277 mg/dl (S=74.5%, E=84.1%, PPV=64.4% and NPV=83%) Conclusions: Low levels of fibrinogen were observed in the group with severe PPH and in those with complications, this observation was statistically significant. The prognostic value of fibrinogen in predicting the severity of bleeding and its complications exists, presenting a good diagnostic capacity.