The Role of the Fibrinogen-Albumin Ratio in Predicting Fetal and Maternal Outcomes in Pregnancies Complicated by Placental Abruption

Öz

To investigate the role of the fibrinogen-albumin ratio (FAR.) in predicting fetal and maternal outcomes in patients with placental abruption (PA). This study was retrospectively designed at a single tertiary care center between June 2019 and June 2024. A total of 190 patients with PA were included. The patients were divided into two groups based on the degree of PA. There were 54 patients in the total PA group and 136 patients in the partial PA group. Fibrinogen levels were found to be statistically significantly lower in the total PA group compared to partial PA group (p<0.001). There was also a statistically significant difference in FAR results (p<0.001). Gestational age at diagnosis, gestational age at delivery, and birth weight were lower in the total PA group (p<0.001). Intrauterine fetal loss was more frequent in the total PA group (p<0.001). The rate of maternal admission to the intensive care unit was also higher in the total PA group (p<0.001). Receiver operating characteristic analysis revealed that FAR had an optimal cut-off value of 0.07, at which it predicted maternal intensive care unit admission with 82% sensitivity and 73% specificity (area under the curve=0.855; p<0.001). As the degree of PA increases, fetal and maternal outcomes worsen. FAR was found to be lower in patients with total PA, and it demonstrated high sensitivity in predicting adverse maternal outcomes. Being a simple and feasible measure, FAR could assist clinicians in managing cases of PA.

Anahtar Kelimeler

• albumin
• fibrinogen
• fibrinogen-albumin ratio
• placental abruption

Ablasyo Plasenta ile Komplike Olan Gebeliklerde Fetal ve Maternal Sonuçların Tahmininde Fibrinojen-Albümin Oranının Rolü

Öz

Plasenta dekolmanı (PA) olan hastalarda fetal ve maternal sonuçları öngörmede fibrinojen-albümin oranının (FAR) rolünü araştırmak. Bu çalışma, Haziran 2019 ile Haziran 2024 tarihleri arasında tek bir üçüncü basamak sağlık merkezinde retrospektif olarak tasarlanmıştır. Çalışmaya PA'lı toplam 190 hasta dahil edilmiştir. Hastalar PA derecesine göre iki gruba ayrılmıştır. Toplam PA grubunda 54 hasta ve kısmi PA grubunda 136 hasta bulunmaktadır. Fibrinojen düzeylerinin, kısmi PA grubuna kıyasla toplam PA grubunda istatistiksel olarak anlamlı derecede düşük olduğu bulunmuştur (p<0,001). FAR sonuçlarında da istatistiksel olarak anlamlı bir fark bulunmuştur (p<0,001). Tanı anındaki gebelik yaşı, doğum anındaki gebelik yaşı ve doğum ağırlığı, toplam PA grubunda daha düşük bulunmuştur (p<0,001). İntrauterin fetal kayıp, toplam PA grubunda daha sık görülmüştür (p<0,001). Yoğun bakım ünitesine anne yatışı oranı toplam PA grubunda daha yüksekti (p<0,001). Alıcı çalışma karakteristiği analizi, FAR'ın 0,07'lik optimum bir kesme değerine sahip olduğunu ve bu değerde %82 duyarlılık ve %73 özgüllükle anne yoğun bakım ünitesine yatışını öngördüğünü ortaya koydu (eğri altında kalan alan = 0,855; p<0,001). PA derecesi arttıkça fetal ve maternal sonuçlar kötüleşmektedir. FAR'ın toplam PA'lı hastalarda daha düşük olduğu ve olumsuz maternal sonuçları öngörmede yüksek duyarlılık gösterdiği bulundu. Basit ve uygulanabilir bir ölçüm olan FAR, klinisyenlerin PA vakalarını yönetmesine yardımcı olabilir.

Anahtar Kelimeler

• albumin
• fibrinojen
• fibrinojen-albumin oranı
• plasenta dekolma

Kaynakça

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