Increased bleeding after birth is common. More severe bleeding is less frequent and often unpredictable. Today, in addition to the measures taken by gynecologists, medication, coagulation factor surgery and, most recently, blood reserves are available as therapy. This is intended to stop the bleeding and replace the blood loss. In earlier, previously published studies, we were able to demonstrate a strong correlation between a blood coagulation factor (factor 13) and postnatal blood loss. The next logical step in this study is to investigate whether the use of coagulation factor 13 at an earlier stage of bleeding than usual actually helps to reduce blood loss and thus effectively prevent further complications associated with bleeding.
Aim of the study
The aim is to test whether postpartum blood loss and the associated complications can be reduced by substituting factor 13 at an early stage of bleeding.
Who can take part?
Pregnant women aged 18 and over who are due to give birth in one of the participating hospitals (in addition to the main study center USZ, these are the university hospitals of Basel, Bern, Geneva and Lausanne; the cantonal hospitals of Baden, St. Gallen, Winterthur and Zollikerberg Hospital). Women with a planned caesarean section, multiple pregnancies or known coagulation disorders are excluded from the study.
Procedure
You will be included in the study if you have heavy bleeding immediately after the birth. In this case, you will be randomly assigned to either the study group (standard treatment plus coagulation factor 13) or the control group (standard treatment only). If you do not have increased bleeding, you will not be included in the study without further measures.
In the event of heavy postnatal bleeding, we measure the blood loss and compare it in both groups. Six to nine weeks after the birth, we will also ask you about your state of health by telephone. In an additional project (only at the USZ and the Cantonal Hospital of St. Gallen), we are also investigating which coagulation factors are important before and after birth. We require your separate consent for the collection of your blood samples for research purposes and for the further use of your health-related data and your blood samples. If you do not wish to do so, it is possible for you to take part in the intervention study with the possible administration of coagulation factor 13, but not in the additional project with the collection of blood samples.
Compensation
none
Original study name
Early factor XIII replacement in postpartum hemorrhage: multi-center, randomized, controlled, investigator-initiated trial
BASEC number
2024-00374
Financing
This study is funded by the Swiss National Science Foundation SNSF.
Responsible departments
- Department of Obstetrics, University Hospital Zurich, USZ
- Women’s Clinic, University Hospital Basel
- Département femme-mère-enfant, Centre hospitalier universitaire vaudois (CHUV)
- Maternité – Hôpitaux universitaires de Genève (HUG)
- Women’s Clinic Cantonal Hospital St. Gallen
- Clinic for Obstetrics & Prenatal Diagnostics, Cantonal Hospital Baden
- Women’s Clinic, Zollikerberg Hospital
- University Clinic for Gynecology, Inselspital Bern
- Clinic for Obstetrics, Winterthur Cantonal Hospital