Hypofibrinogenemia in pregnancy and the puerperium

1.1. The total protein and fibrinogen levels have been followed in 45 cases of normal pregnancy, labor, and in the early puerperium. The protein levels show a slightly downward trend with a rise to normal just prior to delivery, the fibrinogen levels show an upward trend to delivery. The average fibrinogen level at delivery is 325 mg. per 100 c.c.2.2. Fresh blood is the physiological therapy for coagulation defects during pregnancy. Fresh blood and fibrinogen should be readily available in obstetrical units.3.3. The classification of abruptio placentae on the basis of good or poor clotting power of the blood is recommended.4.4. The necessity for complete restoration of clotting power in these serious cases and the danger of operating before this has been carried out are stressed.5.5. With a dead fetus, so long as the fibrinogen level is maintained, interference is unjustifiable.6.6. The coincidence of the nonindicated usage of pituitary extract and amniotic fluid embolism is pointed out.7.7. The management of secondary postpartum hemorrhage associated with coagulation defects is discussed.