{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:06:59Z","timestamp":1790723219620,"version":"4.1.0"},"reference-count":36,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: Hereditary Fibrinogen Disorders (HFDs) are a group of rare, inherited coagulation disorders with a wide spectrum of clinical presentations, ranging from asymptomatic cases to severe bleeding or thrombotic events. Among these, hereditary hypofibrinogenemia (HH) poses particular challenges in obstetric care due to its unpredictable course and limited evidence-based guidelines. Case Presentation: This case report describes the novel obstetrical management of a 37 years old multiparous woman with severe HH (SHH) guided not only by fibrinogen levels but also by rotational thromboelastometry (ROTEM\u00ae), a global test of hemostasis using specific parameters such as FIBTEM\u00ae and NATEM\u00ae assays. Despite persistent low fibrinogen levels during labor and peripartum (&lt;100 mg\/dL), favorable maternal and neonatal outcomes were achieved by relying on ROTEM\u00ae-based parameters to guide clinical decisions. Conclusions: Current recommendations for managing pregnancies in women with HFDs are largely based on expert consensus and exclusively use fibrinogen levels. This case supports the use of specific assays (FIBTEM\u00ae and NATEM\u00ae) of the ROTEM\u00ae global test of hemostasis as valuable tools in the obstetric management of women with HH. The use of FIBTEM\u00ae and NATEM\u00ae assays could provide individualized perinatal care, avoiding unnecessary therapeutic interventions and aiming for optimal perinatal outcomes.<\/jats:p>","DOI":"10.3390\/diagnostics15131671","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T11:37:51Z","timestamp":1751283471000},"page":"1671","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Severe Hereditary Hypofibrinogenemia in Pregnancy: A Case Report of a Novel Obstetrical Management with Thromboelastometry Guided Fibrinogen Supplementation"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5897-8958","authenticated-orcid":false,"given":"Grigorios","family":"Karampas","sequence":"first","affiliation":[{"name":"Second Department of Obstetrics and Gynaecology, \u201cAretaieio\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, PC 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6443-7621","authenticated-orcid":false,"given":"Konstantinos","family":"Karkalemis","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynaecology, \u201cAretaieio\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, PC 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3669-9573","authenticated-orcid":false,"given":"Anastasia","family":"Bagiasta","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynaecology, \u201cAretaieio\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, PC 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Ekaterini","family":"Lefaki","sequence":"additional","affiliation":[{"name":"Laboratory of Heamatology, Blood Transfusion Unit, \u201cAretaieio\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, PC 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1788-3818","authenticated-orcid":false,"given":"Dimitra","family":"Metallinou","sequence":"additional","affiliation":[{"name":"Department of Midwifery, School of Health and Care Sciences, University of West Attica, PC 12243 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chryssoula","family":"Staikou","sequence":"additional","affiliation":[{"name":"First Department of Anesthesiology, \u201cAretaieio\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, PC 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4316-7305","authenticated-orcid":false,"given":"Zoi","family":"Iliodromiti","sequence":"additional","affiliation":[{"name":"Neonatal Department, \u201cAretaieio\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, PC 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9972-8901","authenticated-orcid":false,"given":"Rozeta","family":"Sokou","sequence":"additional","affiliation":[{"name":"Neonatal Department, \u201cAretaieio\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, PC 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kassandra","family":"Tataropoulou","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Second Department of Pediatrics, \u201cAglaia Kyriakou\u201d Children\u2019s Hospital, Medical School, National and Kapodistrian University of Athens, PC 11573 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodora","family":"Boutsikou","sequence":"additional","affiliation":[{"name":"Neonatal Department, \u201cAretaieio\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, PC 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4967-2505","authenticated-orcid":false,"given":"Makarios","family":"Eleftheriades","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynaecology, \u201cAretaieio\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, PC 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8479-6517","authenticated-orcid":false,"given":"Nikolaos","family":"Vlahos","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynaecology, \u201cAretaieio\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, PC 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4112-8396","authenticated-orcid":false,"given":"Panagiotis","family":"Christopoulos","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynaecology, \u201cAretaieio\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, PC 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7226-6452","authenticated-orcid":false,"given":"Marianna","family":"Politou","sequence":"additional","affiliation":[{"name":"Laboratory of Heamatology, Blood Transfusion Unit, \u201cAretaieio\u201d University Hospital, Medical School, National and Kapodistrian University of Athens, PC 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1055\/s-2003-38832","article-title":"Coagulation Factor Deficiencies and Pregnancy Loss","volume":"29","author":"Inbal","year":"2003","journal-title":"Semin. 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