Iranian Society of Gynecology Oncology

Document Type : Original Research Article


1 Department of Anesthesiology, Anesthesia Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Obstetrics and Gynecology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Department of Community Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Department of Obstetrics and Gynecology, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5 Department of Anesthesiology, Clinical Research and Development Unit, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran


Background & Objective: Postpartum hemorrhage is the most common cause of maternal morbidity and mortality, which can occur unexpectedly without warning, and without any underlying causes. We hypothesized that administering fibrinogen concentrate to cesarean section patients before surgery would reduce perioperative blood loss.
Materials & Methods: In this double-blind randomized controlled parallel group study, a single dosage of fibrinogen concentrate or a placebo was given to 260 cesarean section patients at random (by G*Power software, Heinrich-Heine-Universität Düsseldorf, Germany) in a university-affiliated general hospital between November 11, 2022, to January 8, 2023. Individuals in the fibrinogen group received a dose of one gram of fibrinogen concentrate and those in the placebo group received normal saline solution with the same volume in the placebo group. Total blood loss was the primary outcome of this study.
Results: A total of 280 cases were screened and 260 were randomized. With a P-value of 0.001, the median (IQR) volume of bleeding in the fibrinogen group was 660 (341.25) mL, as opposed to 790 (475.00) mL in the placebo group. Comparatively, only 10 (7.7%) of the fibrinogen group and 26 (20%) of the placebo group required blood transfusions (P=0.006). No adverse event related to fibrinogen was reported.
Conclusion: Empiric treatment with fibrinogen concentrate results in reduced blood loss.


 Empiric treatment with fibrinogen concentrate results in reduced blood loss.


Main Subjects

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