@article{oai:tsukuba.repo.nii.ac.jp:00039199,
 author = {小畠, 真奈 and 八木, 洋也 and 大原, 玲奈 and 濱田, 洋実 and Endo-Kawamura, Naho and Obata-Yasuoka, Mana and Yagi, Hiroya and Ohara, Rena and Nagai, Yuko and Mayumi, Miyuki and Abe, Kanako and Hamada, Hiromi},
 issue = {5},
 journal = {Journal of perinatal medicine},
 month = {Jul},
 note = {Aims: 
This study aimed to determine effective predictive factors for primary postpartum hemorrhage (PPH) among clinical blood parameters associated with coagulation and fibrinolysis and demographic characteristics.

Methods:
 We retrospectively studied 1032 women who underwent determinations of clinical blood parameters at gestational week (GW) 29–32 and GW 35–37 and gave birth to singleton infants at our hospital between January 2011 and December 2013. PPH was defined as estimated blood loss ≥700 mL. Multivariate logistic regression analyses were used to determine independent risk factors and odds ratios (OR) for PPH.

Results:
 PPH occurred in 104 of 1032 women (10%). Three blood variables, fibrinogen level <4.0 g/L (OR [95% CI], 1.96 [1.18–3.27]), antithrombin activity <85% of normal activity level (1.84 [1.05–3.21]), and D-dimer level >2.7 μg/mL (2.03 [1.29–3.19]) at GW 35–37, and three demographic characteristics, maternal age ≥35 years (1.75 [1.15–2.68]), BMI >28.2 kg/m2 on admission for childbirth (1.95 [1.20–3.16]), and previous cesarean delivery (2.77 [1.31–5.83]), were identified as independent risk factors for PPH.

Conclusion:
 Among blood parameters, higher D-dimer levels and lower levels of antithrombin activity and fibrinogen in late gestation were independent risk factors for PPH.},
 pages = {551--556},
 title = {Higher D-dimer level in the early third trimester predicts the occurrence of postpartum hemorrhage},
 volume = {44},
 year = {2016}
}