The use of fibrinogen concentrate to correct hypofibrinogenaemia rapidly during obstetric haemorrhage

Standard haemostatic tests following major obstetric haemorrhage

“…However, our group and others have reported good haemostatic responses to the use of fibrinogen concentrate to treat PPH. [25][26][27] Data reported here demonstrate that FFP was used much more often than would be expected if current massive haemorrhage guidelines had been followed. 7,11,12 These guidelines suggest that during major haemorrhage, FFP should be infused to maintain a PT and aPTT <1.5 times normal and it has been estimated that coagulation tests are likely to become this abnormal when a 1.5-2 blood volume bleed (7.5-10 L) has occurred.…”

Fibrin-based clot formation as an early and rapid biomarker for progression of postpartum hemorrhage: a prospective study

“…Anecdotal, uncontrolled reports suggest improved hemostasis associated with increasing fibrinogen levels. [31][32][33][34][35] It is not known whether a low fibrinogen or fibrin-based clot formation causes progression of PPH or reflects the severity of the bleed. There is biological plausibility to support causality, because these factors are critical for clot formation.…”

Haemostatic management of obstetric haemorrhage

“…The literature consists of case reports and series of women with significant hypofibrinogenaemia. It is easy to mix and administer in an acute situation, which has made it popular in some centres, and anecdotal, uncontrolled studies report improved clinical haemostasis associated with increased fibrinogen levels [43,[46][47][48][49]. Increasing the fibrinogen level by 1 g.l…”