Which single laboratory value measured early in postpartum hemorrhage is the best predictor of subsequent progression to severe hemorrhage?

• A Fibrinogen concentration below 2 g/L ✓
• B Prothrombin time prolongation beyond 3 seconds
• C Platelet count below 100 x 10^9/L
• D Hemoglobin fall below 8 g/dL

Explanation

Fibrinogen falls earlier than other coagulation markers in obstetric hemorrhage because pregnancy raises baseline levels to 4 to 6 g/L, so a value below 2 g/L signals substantial consumption and strongly predicts progression to severe PPH. Platelet counts and prothrombin times typically remain near normal until much later because of their wide physiological reserve, making them insensitive early markers compared with fibrinogen.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.