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

Yıl 2026, Cilt: 48 Sayı: 1, 68 - 74, 15.12.2025

Zahid Ağaoğlu , Atakan Tanacan , Gülnihal Reyhan Toptaş , Merve Ozturk Agaoglu , Göksun İpek , Ezgi Başaran , Hakkı Şerbetçi , Dilek Sahin

https://doi.org/10.20515/otd.1755960

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

• 1. Brandt JS, Ananth CV. Placental abruption at near-term and term gestations: pathophysiology, epidemiology, diagnosis, and management. Am J Obstet Gynecol. 2023;228(5s):S1313-s1329.
• 2. Tikkanen M. Placental abruption: epidemiology, risk factors and consequences. Acta Obstet Gynecol Scand. 2011;90(2):140-149.
• 3. Jenabi E, Salimi Z, Ayubi E, Bashirian S, Salehi AM. The environmental risk factors prior to conception associated with placental abruption: an umbrella review. Syst Rev. 2022;11(1):55.
• 4. Tikkanen M, Nuutila M, Hiilesmaa V, Paavonen J, Ylikorkala O. Clinical presentation and risk factors of placental abruption. Acta Obstet Gynecol Scand. 2006;85(6):700-705.
• 5. Alouini S, Valery A, Lemaire B, Evrard ML, Belin O. Diagnosis and Management of Pregnant Women With Placental Abruption and Neonatal Outcomes. Cureus. 2022;14(1):e21120.
• 6. Levy M, Gonen N, Kovo M, Schreiber L, Marom O, Barda G, et al. Does macroscopic estimation of the extent of placental abruption correlate with pregnancy outcomes? Eur J Obstet Gynecol Reprod Biol. 2020;254:188-194.
• 7. Wang L, Matsunaga S, Mikami Y, Takai Y, Terui K, Seki H. Pre-delivery fibrinogen predicts adverse maternal or neonatal outcomes in patients with placental abruption. J Obstet Gynaecol Res. 2016;42(7):796-802.
• 8. Köroğlu N, Tayyar A, Soydar A, Albayrak N, Aydın T, Çetin BA. Pre-delivery fibrinogen level is a predictor for severity of placental abruption. Eur J Obstet Gynecol Reprod Biol X. 2023;20:100264.
• 9. Su J, Yang Y, Cao Y, Yin Z. The predictive value of pre-delivery laboratory test results for the severity of placental abruption and pregnancy outcome. Placenta. 2021;103:220-225.
• 10. Xu Q, Zhu C, Zhang Q, Hu Z, Ji K, Qian L. Association between fibrinogen-to-albumin ratio and prognosis of patients with heart failure. Eur J Clin Invest. 2023;53(10):e14049.
• 11. Sawatani T, Shirakabe A, Shighihara S, Nishigoori S, Kiuchi K, Tani K, et al. Fibrinogen-to-Albumin Ratio in Patients with Acute Heart Failure. Int Heart J. 2024;65(4):638-649.
• 12. Fu Y, Yu Y, Zhou Y, Li T, Xie Y, Wang Y, et al. The fibrinogen-albumin ratio as a novel prognostic factor for elderly patients with osteosarcoma. Medicine (Baltimore). 2023;102(36):e34926.
• 13. Usta CS, Atik TK, Ozcaglayan R, Bulbul CB, Camili FE, Adali E. Does the fibrinogen/albumin ratio predict the prognosis of pregnancies with abortus imminens? Saudi Med J. 2021;42(3):255-263.
• 14. Cimsir MT, Yildiz MS. Could fibrinogen to albumin ratio be a predictive marker for recurrent pregnancy loss. Int J Clin Pract. 2021;75(10):e14520.
• 15. Hladky K, Yankowitz J, Hansen WF. Placental abruption. Obstet Gynecol Surv. 2002;57(5):299-305.
• 16. Downes KL, Grantz KL, Shenassa ED. Maternal, Labor, Delivery, and Perinatal Outcomes Associated with Placental Abruption: A Systematic Review. Am J Perinatol. 2017;34(10):935-957.
• 17. Suzuki R, Furuya N, Hasegawa J, Homma C, Iwahata Y, Suzuki N. Ultrasonographic findings of placental abruption observed on superb microvascular imaging. Taiwan J Obstet Gynecol. 2022;61(4):713-716.
• 18. Fadl SA, Linnau KF, Dighe MK. Placental abruption and hemorrhage-review of imaging appearance. Emerg Radiol. 2019;26(1):87-97.
• 19. Ananth CV, Lavery JA, Vintzileos AM, Skupski DW, Varner M, Saade G, et al. Severe placental abruption: clinical definition and associations with maternal complications. Am J Obstet Gynecol. 2016;214(2):272.e271-272.e279.
• 20. Çiçekli E, Sayan S, Kotan D. Availability of Fibrinogen/Albumin ratio in MS attack. Mult Scler Relat Disord. 2022;60:103674.
• 21. Lee LE, Pyo JY, Ahn SS, Song JJ, Park YB, Lee SW. Fibrinogen to albumin ratio reflects the activity of antineutrophil cytoplasmic antibody-associated vasculitis. J Clin Lab Anal. 2021;35(4):e23731.
• 22. Ren H, Liu W, Niu A, Zhao X. Fibrinogen to albumin ratio, a novel serum indicator for evaluating the severity of preeclampsia: A single-center retrospective study. Medicine (Baltimore). 2023;102(13):e33419.
• 23. Tikkanen M, Luukkaala T, Gissler M, Ritvanen A, Ylikorkala O, Paavonen J, et al. Decreasing perinatal mortality in placental abruption. Acta Obstet Gynecol Scand. 2013;92(3):298-305.