{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:08:54Z","timestamp":1790125734763,"version":"4.0.1"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Increasingly, point\u2010of\u2010care testing has been adopted to rapidly assess fibrinogen levels for managing severe postpartum hemorrhage; however, evidence regarding its impact on clinical outcomes is limited. We evaluated whether implementing a transfusion strategy guided by point\u2010of\u2010care testing was associated with changes in blood loss and transfusion outcomes in patients with severe postpartum hemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective single\u2010center interrupted time series analysis at a tertiary perinatal referral center in Japan. Consecutive patients with severe postpartum hemorrhage (blood loss, \u2265\u20091000\u2009mL) requiring emergency transfer between April 2014 and March 2019 were included. A dry hematology\u2013based point\u2010of\u2010care testing system combined with a standardized transfusion protocol was introduced in March 2016. The primary outcome was total blood loss. Secondary outcomes included transfusion volumes and in\u2010hospital maternal mortality. Segmented regression models were used to estimate changes in level and trend before and after implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 142 patients included (52 before and 90 after intervention implementation), baseline severity indicators were higher in the pre\u2010intervention period. Implementation of the point\u2010of\u2010care testing\u2013guided transfusion strategy was not associated with significant changes in total blood loss or volumes of red blood cells or fresh frozen plasma transfused. Similar findings were observed for in\u2010hospital outcomes. Results were consistent across the adjusted and sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implementing a point\u2010of\u2010care testing\u2013guided transfusion strategy was not associated with significant improvements in blood loss or transfusion outcomes among patients with severe postpartum hemorrhage at our tertiary referral center. These findings should be interpreted within the context of this institutional setting and do not exclude the possibility that point\u2010of\u2010care testing may provide clinical benefit in other patient populations or healthcare settings. Further studies are needed to identify the clinical settings in which point\u2010of\u2010care testing\u2013guided transfusion strategies are most effective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70482","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T07:58:23Z","timestamp":1788249503000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Point\u2010of\u2010Care Fibrinogen Testing and Hemorrhage Outcomes in Severe Postpartum Hemorrhage: An Interrupted Time Series Analysis"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7820-5557","authenticated-orcid":false,"given":"Eishin","family":"Nakamura","sequence":"first","affiliation":[{"name":"Center for Maternal, Fetal and Neonatal Medicine Saitama Medical Center, Saitama Medical University  Saitama Japan"},{"name":"Department of Health Data Science Yokohama City University  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2592-9951","authenticated-orcid":false,"given":"Shigetaka","family":"Matsunaga","sequence":"additional","affiliation":[{"name":"Center for Maternal, Fetal and Neonatal Medicine Saitama Medical Center, Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiko","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Center for Maternal, Fetal and Neonatal Medicine Saitama Medical Center, Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3872-8481","authenticated-orcid":false,"given":"Yasushi","family":"Takai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Saitama Medical Center Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(24)00560-6"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2007.02297.x"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1513247"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.09.008"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2022.100778"},{"issue":"1","key":"e_1_2_13_7_1","first-page":"348","article-title":"Interrupted Time Series Regression for the Evaluation of Public Health Interventions: A Tutorial","volume":"46","author":"Bernal J. L.","year":"2017","journal-title":"International Journal of Epidemiology"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.4103\/sja.SJA_543_18"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002351"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1547372"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2023.03.018"},{"key":"e_1_2_13_12_1","unstructured":"Japan Society of Obstetrics and Gynecology \u201cGuidelines for the Management of Obstetric Critical Hemorrhage 2022 \u201d2022 https:\/\/www.jsog.or.jp\/activity\/pdf\/shusanki_taioushishin2022.pdf."},{"key":"e_1_2_13_13_1","unstructured":"RCT \u201cR: A Language and Environment for Statistical Computing \u201d2025 https:\/\/www.R\u2010project.org\/."},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2018.05.026"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004686"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2025.109339"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2026.109715"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.13417"}],"container-title":["Journal of Obstetrics and Gynaecology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.70482","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jog.70482","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.70482","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:52:24Z","timestamp":1790124744000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.70482"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":17,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/jog.70482"],"URL":"https:\/\/doi.org\/10.1111\/jog.70482","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"value":"1341-8076","type":"print"},{"value":"1447-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-06-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70482"}}