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This retrospective case\u2013control study included nine patients with clinical AFE (\u201cAFE group\u201d) and 78 patients with PPH managed at our tertiary care perinatal centre between January 2014 and March 2016. Patients meeting the Japanese diagnostic criteria for AFE were stratified into cardiopulmonary collapse-type AFE and disseminated intravascular coagulation (DIC)-type AFE groups. The relationship between blood loss and fibrinogen at onset was examined to compare DIC severity. Vital signs at onset were not significantly different. The AFE group had significantly less blood loss at onset (1506\u00a0mL vs 1843\u00a0mL, P\u2009=\u20090.0163), significantly more blood loss 2\u00a0h post-onset (3304\u00a0mL vs 1996\u00a0mL, P\u2009&lt;\u20090.0001) and more severe coagulopathy and fibrinolysis. The blood loss\/fibrinogen (B\/F) ratio at onset was significantly higher in the DIC-type AFE group (23.15\u2009\u00b1\u20098.07 vs 6.28\u2009\u00b1\u20093.35\u00a0mL\u00a0dL\/mg, P\u2009&lt;\u20090.0001). AFE was complicated by catastrophic DIC irrespective of blood loss at onset. Fibrinogen exhibited the strongest correlation among test findings at onset. The B\/F ratio may help differentiate PPH from DIC-type AFE and diagnose clinical AFE, facilitating optimal replacement of coagulation factors during the early stages.<\/jats:p>","DOI":"10.1038\/s41598-021-87685-y","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T11:36:09Z","timestamp":1618572969000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Fibrinogen may aid in the early differentiation between amniotic fluid embolism and postpartum haemorrhage: a retrospective chart review"],"prefix":"10.1038","volume":"11","author":[{"given":"Shigetaka","family":"Matsunaga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroko","family":"Masuko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Takai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohiro","family":"Kanayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Seki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,16]]},"reference":[{"key":"87685_CR1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/1471-2393-12-7","volume":"12","author":"M Knight","year":"2012","unstructured":"Knight, M. et al. 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