{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:07:16Z","timestamp":1790723236129,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T00:00:00Z","timestamp":1711065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["PR\u2010PRU\u20101217\u201021202"],"award-info":[{"award-number":["PR\u2010PRU\u20101217\u201021202"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pregnant women with a fibrinogen level &lt;2\u2009g\/L represent a high\u2010risk group that is associated with severe postpartum hemorrhage and other complications. Women who would qualify for fibrinogen therapy are not yet identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>A population\u2010based cross\u2010sectional study was conducted using the UK Obstetric Surveillance System between November 2017 and October 2018 in any UK hospital with a consultant\u2010led maternity unit. Any woman pregnant or immediately postpartum with a fibrinogen &lt;2\u2009g\/L was included. Our aims were to determine the incidence of fibrinogen &lt;2\u2009g\/L in pregnancy, and to describe its causes, management and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over the study period 124 women with fibrinogen &lt;2\u2009g\/L were identified (1.7 per 10\u2009000 maternities; 95% confidence interval 1.4\u20132.0 per 10\u2009000 maternities). Less than 5% of cases of low fibrinogen were due to preexisting inherited dysfibrinogenemia or hypofibrinogenemia. Sixty percent of cases were due to postpartum hemorrhage caused by placental abruption, atony, or trauma. Amniotic fluid embolism and placental causes other than abruption (previa, accreta, retention) were associated with the highest estimated blood loss (median 4400\u2009mL) and lowest levels of fibrinogen. Mortality was high with two maternal deaths due to massive postpartum hemorrhage, 27 stillbirths, and two neonatal deaths.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Fibrinogen &lt;2\u2009g\/L often, but not exclusively, affected women with postpartum hemorrhage due to placental abruption, atony, or trauma. Other more rare and catastrophic obstetrical events such as amniotic fluid embolism and placenta accreta also led to low levels of fibrinogen. Maternal and perinatal mortality was extremely high in our cohort.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14828","type":"journal-article","created":{"date-parts":[[2024,3,23]],"date-time":"2024-03-23T03:43:25Z","timestamp":1711165405000},"page":"1339-1347","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Management and outcomes of women with low fibrinogen concentration during pregnancy or immediately postpartum: A UK national population\u2010based cohort study"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1176-0991","authenticated-orcid":false,"given":"Caroline","family":"Diguisto","sequence":"first","affiliation":[{"name":"National Perinatal Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford UK"},{"name":"P\u00f4le de Gyn\u00e9cologie Obst\u00e9trique, M\u00e9decine F\u0153tale, M\u00e9decine et Biologie de la Reproduction, center Olympe de Gouges, CHRU de Tours Universit\u00e9 de Tours  Tours France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elfreda","family":"Baker","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7414-4950","authenticated-orcid":false,"given":"Simon","family":"Stanworth","sequence":"additional","affiliation":[{"name":"NHS Blood and Transplant  Oxford UK"},{"name":"Oxford University Hospitals NHS Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6410-1324","authenticated-orcid":false,"given":"Peter W.","family":"Collins","sequence":"additional","affiliation":[{"name":"Institute of Infection and Immunity Cardiff University  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2107-7990","authenticated-orcid":false,"given":"Rachel E.","family":"Collis","sequence":"additional","affiliation":[{"name":"Department of Anaesthetics Cardiff and Vale University Health Board  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1984-4575","authenticated-orcid":false,"given":"Marian","family":"Knight","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford 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Lives, Improving Mothers' Care \u2010 Lessons Learned to Inform Maternity Care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2018\u201320","author":"Knight M","year":"2022"},{"key":"e_1_2_13_16_1","volume-title":"MBRRACE\u2010UK Perinatal Mortality Surveillance Report, UK Perinatal Deaths for Births from January to December 2018","author":"Draper ES","year":"2020"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-04-567891"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2009.04.002"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeu086"}],"container-title":["Acta Obstetricia et Gynecologica 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