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Article

Predelivery Haemostatic Biomarkers in Women with Non-Severe Postpartum Haemorrhage

by
Claire de Moreuil
1,2,3,*,
Brigitte Pan-Petesch
1,4,
Dino Mehic
3,
Daniel Kraemmer
3,
Theresa Schramm
3,
Casilda Albert
5,
Christophe Trémouilhac
6,
Sandy Lucier
7,
Hubert Galinat
8,
Liana Le Roux
9,
Johanna Gebhart
3,
Francis Couturaud
1,2,
Alisa S. Wolberg
10,
Cihan Ay
3 and
Ingrid Pabinger
3
1
UMR 1304 GETBO, INSERM, University of Brest, 29200 Brest, France
2
Internal Medicine, Vascular Medicine and Pneumology Department, Centre Hospitalier Universitaire de Brest, 29200 Brest, France
3
Department of Medicine I, Clinical Division of Haematology and Haemostaseology, Medical University of Vienna, 1090 Vienna, Austria
4
Center for Haemophilia Treatment, Haematology, Centre Hospitalier Universitaire de Brest, 29200 Brest, France
5
Gynecology and Obstetrics Department, Centre Hospitalier Universitaire de Brest, 29200 Brest, France
6
Gynecology and Obstetrics Department, Morlaix Hospital, 29672 Morlaix, France
7
CIC1412, INSERM, Centre Hospitalier Universitaire de Brest, 29200 Brest, France
8
Haemostasis Laboratory, Centre Hospitalier Universitaire de Brest, 29200 Brest, France
9
CIC-RB Ressources Biologiques (UF 0827), Centre Hospitalier Universitaire de Brest, 29200 Brest, France
10
Department of Pathology and Laboratory Medicine, UNC Blood Research Center, University of North Carolina at Chapel Hill, NC 27514, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(14), 4231; https://doi.org/10.3390/jcm13144231
Submission received: 21 May 2024 / Revised: 17 July 2024 / Accepted: 18 July 2024 / Published: 19 July 2024
(This article belongs to the Special Issue Clinical Risks and Perinatal Outcomes in Pregnancy and Childbirth)
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Abstract

Background: Postpartum haemorrhage (PPH) is a frequent complication of childbirth that is difficult to predict. Predelivery coagulation biomarkers may help to guide preventive strategies. Our objective was to evaluate the association of predelivery haemostatic biomarkers with non-severe PPH. Methods: A nested case-control study was conducted within the « Study of Biological Determinants of Bleeding Postpartum » in order to compare different haemostatic biomarkers in plasma from pregnant women with non-severe PPH (cases) and controls without PPH matched for age, body mass index, term, and mode of delivery. Blood was collected at entry in the delivery room. Global haemostatic assays (thrombin generation assay (TGA) and plasmin generation assay (PGA)) were then performed on freshly thawed aliquots of platelet-poor plasma. Results: A total of 370 pregnant women (185 cases and 185 controls) were included. Median [interquartile range] predelivery platelet count was lower in PPH cases than in controls (217 [181–259] versus 242 [196–280] G/L). TGA and PGA parameters were similar between cases and controls. In a subset analysis of vaginal deliveries (n = 144), median predelivery TGA thrombin peak was lower, and median predelivery PGA lag phase was longer in cases compared to controls. In multivariable analysis, only predelivery platelet count was independently associated with non-severe PPH. Conclusions: Predelivery platelet count is associated with non-severe PPH. Differences in other haemostatic parameters are tenuous, questioning their usefulness in predicting non-severe PPH.
Keywords: coagulation; plasmin generation; postpartum haemorrhage; predelivery; thrombin generation coagulation; plasmin generation; postpartum haemorrhage; predelivery; thrombin generation

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MDPI and ACS Style

de Moreuil, C.; Pan-Petesch, B.; Mehic, D.; Kraemmer, D.; Schramm, T.; Albert, C.; Trémouilhac, C.; Lucier, S.; Galinat, H.; Le Roux, L.; et al. Predelivery Haemostatic Biomarkers in Women with Non-Severe Postpartum Haemorrhage. J. Clin. Med. 2024, 13, 4231. https://doi.org/10.3390/jcm13144231

AMA Style

de Moreuil C, Pan-Petesch B, Mehic D, Kraemmer D, Schramm T, Albert C, Trémouilhac C, Lucier S, Galinat H, Le Roux L, et al. Predelivery Haemostatic Biomarkers in Women with Non-Severe Postpartum Haemorrhage. Journal of Clinical Medicine. 2024; 13(14):4231. https://doi.org/10.3390/jcm13144231

Chicago/Turabian Style

de Moreuil, Claire, Brigitte Pan-Petesch, Dino Mehic, Daniel Kraemmer, Theresa Schramm, Casilda Albert, Christophe Trémouilhac, Sandy Lucier, Hubert Galinat, Liana Le Roux, and et al. 2024. "Predelivery Haemostatic Biomarkers in Women with Non-Severe Postpartum Haemorrhage" Journal of Clinical Medicine 13, no. 14: 4231. https://doi.org/10.3390/jcm13144231

APA Style

de Moreuil, C., Pan-Petesch, B., Mehic, D., Kraemmer, D., Schramm, T., Albert, C., Trémouilhac, C., Lucier, S., Galinat, H., Le Roux, L., Gebhart, J., Couturaud, F., Wolberg, A. S., Ay, C., & Pabinger, I. (2024). Predelivery Haemostatic Biomarkers in Women with Non-Severe Postpartum Haemorrhage. Journal of Clinical Medicine, 13(14), 4231. https://doi.org/10.3390/jcm13144231

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