Anesthesia
Shahram Sayadi; Shideh Ariana; Maral Hosseinzadeh; Arezou Ashari; Tannaz Yeganegi; Elham Memari; Ebtehaj Heshmatkhah; Dariush Abtahi
Volume 8, Issue 3 , May and June 2023, , Pages 194-203
Abstract
Background & Objective: Postpartum hemorrhage is the most common cause of maternal morbidity and mortality, which can occur unexpectedly without warning, and without any underlying causes. We hypothesized that administering fibrinogen concentrate to cesarean section patients before surgery would ...
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Background & Objective: Postpartum hemorrhage is the most common cause of maternal morbidity and mortality, which can occur unexpectedly without warning, and without any underlying causes. We hypothesized that administering fibrinogen concentrate to cesarean section patients before surgery would reduce perioperative blood loss.Materials & Methods: In this double-blind randomized controlled parallel group study, a single dosage of fibrinogen concentrate or a placebo was given to 260 cesarean section patients at random (by G*Power software, Heinrich-Heine-Universität Düsseldorf, Germany) in a university-affiliated general hospital between November 11, 2022, to January 8, 2023. Individuals in the fibrinogen group received a dose of one gram of fibrinogen concentrate and those in the placebo group received normal saline solution with the same volume in the placebo group. Total blood loss was the primary outcome of this study.Results: A total of 280 cases were screened and 260 were randomized. With a P-value of 0.001, the median (IQR) volume of bleeding in the fibrinogen group was 660 (341.25) mL, as opposed to 790 (475.00) mL in the placebo group. Comparatively, only 10 (7.7%) of the fibrinogen group and 26 (20%) of the placebo group required blood transfusions (P=0.006). No adverse event related to fibrinogen was reported.Conclusion: Empiric treatment with fibrinogen concentrate results in reduced blood loss.
Obstetrics and Gynecology
Maral Hosseinzadeh; Ebtehaj Heshmatkhah; Dariush Abtahi
Volume 8, Issue 3 , May and June 2023, , Pages 285-294
Abstract
Background & Objective: Globally, postpartum hemorrhage (PPH) remains a leading cause of maternal deaths. However, in many low and middle-income countries, information on the magnitude of and risk factors for PPH is scarce. Understanding the relative contributions of different risk factors for ...
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Background & Objective: Globally, postpartum hemorrhage (PPH) remains a leading cause of maternal deaths. However, in many low and middle-income countries, information on the magnitude of and risk factors for PPH is scarce. Understanding the relative contributions of different risk factors for PPH is important. We assessed the incidence of and risk factors for postpartum hemorrhage among women who had a cesarean section in Iran.Materials & Methods: Between March 2021 and March 2022, a prospective cohort study was conducted at a university-affiliated general hospital for women who had a cesarean section in Iran. We used Spearman’s correlation for the variables associated with PPH.Results: Among the 300 women, the overall incidence of postpartum hemorrhage was 15.7%. Risk factors for postpartum hemorrhage among deliveries by cesarean section were: body-mass index, previous PPH, preoperative anemia, and preoperative hypofibrinogenemia.Conclusion: The incidence of postpartum hemorrhage in the cesarean section was high. Extra vigilance in all women with cesarean section could address the risk factors identified.