Association of Plasma Fibrinogen Levels with Severity of Postpartum Hemorrhage: A Cross-Sectional Study

Postpartum hemorrhage (PPH) significantly contributes to maternal morbidity and mortality worldwide. Identifying women at risk for severe PPH early is essential for timely intervention. Objective: To compare the mean plasma fibrinogen level between women with severe and non-severe postpartum hemorrhage (PPH). Methods: This comparative cross-sectional study was performed after its approval from the ethical committee with approval number Admin/PF/722A in the Department of Obstetrics and Gynecology at Cantt General Hospital, Rawalpindi, from July 3, 2025, to December 30, 2025.  A total of 60 women with postpartum hemorrhage were enrolled using a consecutive sampling technique and categorized into non-severe PPH (n=30) and severe PPH (n=30) based on predefined clinical criteria. Plasma fibrinogen levels were assessed at the time of postpartum hemorrhage diagnosis with IBM SPSS version 25.0. A p-value of less than 0.05 was considered statistically significant. Results:  Women experiencing severe PPH exhibited significantly lower fibrinogen levels in comparison to those with non-severe hemorrhage. The mean fibrinogen level in the non-severe postpartum hemorrhage group was 4.55±1.06 g/L, but in the severe PPH group it was 3.53±0.66 g/L, indicating a statistically significant difference (p=0.001). The findings demonstrate an inverse association between fibrinogen concentration and the severity of PPH, showing that lower fibrinogen levels are associated with an increased likelihood of severe bleeding. Conclusions: Reduced fibrinogen levels were significantly associated with severe PPH. Early measurement of fibrinogen may assist in identifying patients at increased risk of severe hemorrhage and ensure prompt management.