Zhongguo shuxue zazhi (Apr 2023)

Comparison of clinical efficacy of fibrinogen concentrate and cryoprecipitate on severe postpartum hemorrhage in puerpera with placenta accreta

  • Jingjing LI,
  • Yajuan XU,
  • Miao ZHANG,
  • Qian OUYANG,
  • Yingqi HAO,
  • Bo WU,
  • Zongzong SUN,
  • Yanjie BAN

DOI
https://doi.org/10.13303/j.cjbt.issn.1004-549x.2023.04.008
Journal volume & issue
Vol. 36, no. 4
pp. 310 – 312

Abstract

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Objective To explore the therapeutic effect of fibrinogen concentrate and cryoprecipitate on severe postpartum hemorrhage in puerpera with placenta accreta under the condition of transfusion of suspended red blood cells and fresh frozen plasma. Methods The clinical data of puerpera with placenta accreta whose blood loss was more than or equal to 50% of the total blood volume within 3 hours in our hospital from January 2009 to June 2021 were retrospectively analyzed. Based on the blood transfusion components, they were divided into fibrinogen concentrate group (group A) and cryoprecipitate group (group B). The coagulation function, blood transfusion units and adverse outcomes of the two groups were analyzed. Results A total of 201 puerpera with severe postpartum hemorrhage due to placenta accreta were included in this study, including 102 cases in group A and 99 cases in group B. The levels of prothrombin time, activated partial thromboplastin time and fibrinogen in group A and group B after blood transfusion were not significantly different from those before delivery (P>0.05). There was no significant difference in blood transfusion volume of suspended red blood cells [(8.18±2.72)U vs (7.90±2.19) U] and fresh frozen plasma [(823.53±258.39)mL vs (804.04±224.94)mL] between group A and group B (P>0.05). There was no significant difference in the incidence of DIC (18.6% vs 21.2%), hysterectomy (26.5% vs 28.3%) and hemorrhagic shock (10.8% vs 13.1%) between group A and group B (P>0.05). Conclusion If puerpera with placenta accreta received both suspended red blood cells and fresh frozen plasma, similar therapeutic effect in severe postpartum hemorrhage was observed between fibrinogen concentrate vs cryoprecipitate. Fibrinogen concentrate has the advantages of rapid preparation, convenient storage and transportation, and can lower the demand for blood products.

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