The fibrinogen/CRP ratio as a new parameter for the diagnosis of disseminated intravascular coagulation in patients with HELLP syndrome and as a predictive factor for neonatal outcome

Objective The aim of this study was to determine if the fibrinogen/C-reactive protein (CRP) ratio could be used in obstetrics as a predictor for a disseminated intravascular coagulation. Study Design One hundred eleven patients with hemolysis, elevated liver enzymes, and low platelet count syndrome...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2013-02, Vol.208 (2), p.118.e1-118.e7
Main Authors: Windsperger, Karin, MD, Lehner, Rainer, MD
Format: Article
Language:English
Subjects:
C-Reactive Protein - metabolism
disseminated intravascular coagulation
Disseminated Intravascular Coagulation - blood
Disseminated Intravascular Coagulation - diagnosis
Female
Fibrinogen - metabolism
fibrinogen/CRP ratio
HELLP syndrome
HELLP Syndrome - blood
Humans
Obstetrics and Gynecology
Predictive Value of Tests
Pregnancy
Pregnancy Complications
Pregnancy Outcome
ROC Curve
Sensitivity and Specificity
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Summary:Objective The aim of this study was to determine if the fibrinogen/C-reactive protein (CRP) ratio could be used in obstetrics as a predictor for a disseminated intravascular coagulation. Study Design One hundred eleven patients with hemolysis, elevated liver enzymes, and low platelet count syndrome at the Department of Obstetrics and Fetomaternal Medicine (General Hospital, Vienna, Austria) were selected and divided into 2 groups (overt disseminated intravascular coagulation, no overt disseminated intravascular coagulation). The classical parameters and the fibrinogen/CRP ratio were compared. The analysis was carried out using IBM SPSS statistical package (SPSS, Inc, Cary, NC). Results The fibrinogen/CRP ratio showed significant differences. The receiver-operating characteristic analysis showed for the ratio (area under the curve, 0.74) significantly better discriminative power than for fibrinogen (area under curve, 0.59). The odds ratio for the fibrinogen/CRP ratio was 7.04. Finally, significant correlations between the ratio and the neonatal outcome were found. Conclusion We suggest the implementation of the fibrinogen/CRP ratio within patients with hemolysis, elevated liver enzymes, and low platelet count syndrome as a diagnostic and prognostic factor for the occurrence of disseminated intravascular coagulation.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2012.11.025