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The Fibrinogen/CRP Ratio as a New Parameter for the Prediction of Disseminated Intravascular Coagulation in Patients with HELLP Syndrome

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Last updated: 03 Jan 2025

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Abstract

Background: The syndrome of Hemolysis, elevated Liver enzymes, and Low Platelet count (HELLP) is a life-threatening variant of preeclampsia, and may be accompanied by disseminated intravascular coagulation (DIC). Recently the fibrinogen/C-reactive protein (CRP) ratio has been suggested as a measurement that predicts onset of DIC. The authors sought to analyze the fibrinogen/CRP ratio among obstetric patients who developed DIC due to HELLP syndrome. Aim: the aim of this study is to determine if the fibrinogen/C-reactive protein (CRP) ratio could be used as a predictor for disseminated intravascular coagulation in obstetrics patients with the HELLP syndrome. Patients and Methods: this study was conducted as a prospective observational study at Ain Shams Maternity Hospital from November 2014 to November 2016 .The study included Patients diagnosed to have Severe Pre Eclamptic Toxemia SPET according to ACOG (2013).Patients was diagnosed  with the HELLP syndrome according to the Martin  classification of HELLP syndrome. Results: the results of our study suggest that replacing the use of fibrinogen levels alone with the fibrinogen/CRP ratio would enhance the diagnostic and prognostic power for DIC in patients with HELLP syndrome. Conclusion: in light of the physiologic changes of the coagulation cascade during gestation, the International Society on Thrombosis and Hemostasis ISTH score could not be implemented in pregnant women alone for the diagnosis and prediction of DIC. Recommendations: further evaluation of the fibrinogen/ CRP ratio is required to determine the generalizability of this marker's use in DIC because of causes such as placental abruption, septic abortion, and failed abortion. Furthermore, prospective studies should be performed to determine the best method to predict if there any new method to predict DIC in patients with the HEELP syndrome.    

DOI

10.12816/0033775

Keywords

HELLP syndrome, Fibrinogen, C-reactive protein, Pre-eclampsia, DIC

Authors

First Name

Tarek Fathy

Last Name

Tamara

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Affiliation

Faculty of Medicine – Ain-Shams University

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Orcid

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First Name

Ihab Fouad

Last Name

Serag

MiddleName

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Affiliation

Faculty of Medicine – Ain-Shams University

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Orcid

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First Name

Tamer El-Sayed Mohamed

Last Name

El-Ghazaly

MiddleName

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Affiliation

Faculty of Medicine – Ain-Shams University

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Orcid

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First Name

Mohammed Adel Ali

Last Name

Ahmed

MiddleName

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Affiliation

Faculty of Medicine – Ain-Shams University

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City

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Orcid

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Volume

65

Article Issue

1

Related Issue

3201

Issue Date

2016-10-01

Receive Date

2018-09-28

Publish Date

2016-10-01

Page Start

634

Page End

642

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_15121.html

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https://ejhm.journals.ekb.eg/service?article_code=15121

Order

20

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

The Fibrinogen/CRP Ratio as a New Parameter for the Prediction of Disseminated Intravascular Coagulation in Patients with HELLP Syndrome

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Article

Created At

22 Jan 2023