New method for determining fibrinogen and FDP threshold criteria by artificial intelligence in cases of massive hemorrhage during delivery

Yasunari Miyagi; Katsuhiko Tada; Ichiro Yasuhi; Yuka Maekawa; Naofumi Okura; Kosuke Kawakami; Ken Yamaguchi; Masanobu Ogawa; Takashi Kodama; Makoto Nomiyama; Tomoya Mizunoe; Takahito Miyake

doi:10.1111/jog.14166

New method for determining fibrinogen and FDP threshold criteria by artificial intelligence in cases of massive hemorrhage during delivery

J Obstet Gynaecol Res. 2020 Feb;46(2):256-265. doi: 10.1111/jog.14166. Epub 2019 Nov 24.

Authors

Yasunari Miyagi^{1

2

3}, Katsuhiko Tada⁴, Ichiro Yasuhi⁵, Yuka Maekawa⁶, Naofumi Okura⁷, Kosuke Kawakami⁷, Ken Yamaguchi^{8

9}, Masanobu Ogawa^{10

11}, Takashi Kodama¹², Makoto Nomiyama¹³, Tomoya Mizunoe¹⁴, Takahito Miyake¹⁵

Affiliations

¹ Medical Data Labo, Okayama, Japan.
² Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Saitama, Japan.
³ Miyake Ofuku Clinic, Okayama, Japan.
⁴ Department of Obstetrics and Gynecology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
⁵ Department of Obstetrics and Gynecology, National Hospital Organization Nagasaki Medical Center, Omura, Japan.
⁶ Department of Obstetrics and Gynecology, National Hospital Organization Mie Chuo Medical Center, Tsu, Japan.
⁷ Department of Obstetrics and Gynecology, National Hospital Organization Kokura Medical Center, Kitakyushu, Japan.
⁸ Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.
⁹ Department of Obstetrics and Gynecology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
¹⁰ Research Center for Environment and Developmental Medical Sciences, Kyusyu University, Fukuoka, Japan.
¹¹ Department of Obstetrics and Gynecology/Clinical Research Institute, National Hospital Organization Kyusyu Medical Center, Fukuoka, Japan.
¹² Department of Obstetrics and Gynecology, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan.
¹³ Department of Obstetrics and Gynecology, National Hospital Organization Saga National Hospital, Saga, Japan.
¹⁴ Department of Obstetrics and Gynecology, National Hospital Organization Kure Medical Center, Kure, Japan.
¹⁵ Department of Obstetrics and Gynecology, Miyake Clinic, Okayama, Japan.

PMID: 31762151
DOI: 10.1111/jog.14166

Abstract

Aim: To investigate the feasibility of a novel method using artificial intelligence (AI), in which the fibrinogen criterion was determined by the quantitative relation between the distributions of fibrin/fibrinogen degradation products (FDPs) and fibrinogen.

Methods: A dataset of 154 deliveries comprising more than 2000 g of blood lost due to hemorrhage, excluding disseminated intravascular coagulation (DIC), among patients from eight national perinatal centers in Japan from 2011 to 2015 were obtained. The fibrinogen threshold criterion was identified by using the function that best fit the distributions of FDP as determined by AI. FDP production was described by differential equations using a dataset containing fibrinogen levels less than the fibrinogen criterion and solved numerically.

Results: A fibrinogen level of 237 mg/dL as the threshold criterion was obtained. The FDP threshold criteria were 2.0 and 8.5 mg/dL for no coagulopathy and a failed coagulation system, respectively.

Conclusion: The fibrinogen threshold criterion for patients with massive hemorrhage excluding DIC at delivery were obtained by selecting the functions that best fit the distributions of FDP data by using AI.

Keywords: artificial intelligence; coagulopathy; delivery; fibrin/fibrinogen degradation product; fibrinogen.

MeSH terms

Adult
Artificial Intelligence
Feasibility Studies
Female
Fibrinogen / analysis*
Fibrinogen / metabolism
Humans
Middle Aged
Postpartum Hemorrhage / blood*
Pregnancy
Young Adult

Substances

Fibrinogen