{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T14:30:54Z","timestamp":1760711454257,"version":"3.41.0"},"reference-count":46,"publisher":"Georg Thieme Verlag KG","issue":"06","funder":[{"DOI":"10.13039\/100009045","name":"Jagiellonian University Medical College","doi-asserted-by":"crossref","award":["N41\/DBS\/001040"],"award-info":[{"award-number":["N41\/DBS\/001040"]}],"id":[{"id":"10.13039\/100009045","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Increased clot permeability and susceptibility to lysis have been reported in women with heavy menstrual bleeding. We hypothesized that similar alterations in fibrin clot properties may also be present in women with postpartum hemorrhage (PPH) of unknown cause.<\/jats:p><jats:p>To determine fibrin clot properties and their determinants in women after PPH of unknown cause.<\/jats:p><jats:p>We studied 52 consecutive women, aged 35 years (27\u201340), after at least 3 months since PPH of unknown cause and 52 matched controls for age, weight, and fibrinogen. Coagulation factors (F), antithrombin, thrombin generation, along with a comprehensive plasma fibrin clot analysis including fibrin polymerization, clot permeability (K\n            s), and fibrinolysis efficiency were determined.<\/jats:p><jats:p>Women with PPH showed reduced activity of FII (\u221210.3%), FV (\u22126.6%), FIX (\u22126.5%), FX (\u22127.2%), and FXI (\u22125.7%) compared with the controls, though all values were within ranges (all p\u2009&lt;\u20090.05). There were no intergroup differences in fibrinogen, FVIII, FXIII, and thrombin generation. The PPH group formed with a delay looser plasma fibrin network (K\n            s; +16.3%, p\u2009=\u20090.008) with lower maximum absorbance and shorter clot lysis time (CLT; \u221213.5%, p\u2009=\u20090.001) compared with the controls. On multivariable logistic regression, PPH was independently associated with higher C-reactive protein (per 1\u2009mg\/L, odds ratio [OR]\u2009=\u20091.70, 95% confidence interval [CI]: 1.09\u20132.68), lower FII (per 1%, OR\u2009=\u20090.93, 95% CI: 0.89\u20130.98), lower FV (per 1%, OR\u2009=\u20090.93, 95% CI: 0.89\u20130.97), and shorter CLT (per 1\u2009minute, OR\u2009=\u20090.94, 95% CI: 0.90\u20130.98).<\/jats:p><jats:p>Prohemorrhagic fibrin clot properties, with lower, though normal coagulation factors, characterize women with PPH of unknown cause, which suggests novel mechanisms contributing to this type of bleeding.<\/jats:p>","DOI":"10.1055\/a-2413-2966","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T22:55:09Z","timestamp":1726095309000},"page":"553-562","source":"Crossref","is-referenced-by-count":1,"title":["Unfavorably Altered Fibrin Clot Phenotype in Women Following Postpartum Hemorrhage of Unknown Cause: Effect of Lower Coagulation Factors"],"prefix":"10.1055","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1764-0747","authenticated-orcid":false,"given":"Magdalena","family":"Pir\u00f3g","sequence":"additional","affiliation":[{"name":"Gynecological Endocrinology Department, Jagiellonian University Medical College, Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micha\u0142","family":"Z\u0105bczyk","sequence":"additional","affiliation":[{"name":"Department of Thromboembolic Disorders, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland"},{"name":"Krakow Centre for Medical Research and Technologies, St. John Paul II Hospital, Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Natorska","sequence":"additional","affiliation":[{"name":"Department of Thromboembolic Disorders, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland"},{"name":"Krakow Centre for Medical Research and Technologies, St. John Paul II Hospital, Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"El\u017cbieta","family":"Broniatowska","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krak\u00f3w, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Jach","sequence":"additional","affiliation":[{"name":"Gynecological Endocrinology Department, Jagiellonian University Medical College, Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anetta","family":"Undas","sequence":"additional","affiliation":[{"name":"Department of Thromboembolic Disorders, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland"},{"name":"Krakow Centre for Medical Research and Technologies, St. John Paul II Hospital, Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,11,5]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1097\/GRF.0000000000000782","article-title":"Postpartum hemorrhage-epidemiology, risk factors, and causes","volume":"66","author":"K Patek","year":"2023","journal-title":"Clin Obstet Gynecol"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1097\/AOG.0000000000002114","article-title":"Pregnancy-related mortality in the United States, 2011-2013","volume":"130","author":"A A Creanga","year":"2017","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1089\/jwh.2020.8874","article-title":"How implicit bias contributes to racial disparities in maternal morbidity and mortality in the United States","volume":"30","author":"B Saluja","year":"2021","journal-title":"J Womens 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