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Article

A Novel Method for Determining Fibrin/Fibrinogen Degradation Products and Fibrinogen Threshold Criteria via Artificial Intelligence in Massive Hemorrhage during Delivery with Hematuria

by
Yasunari Miyagi
1,2,3,*,
Katsuhiko Tada
3,
Ichiro Yasuhi
4,
Keisuke Tsumura
5,
Yuka Maegawa
6,
Norifumi Tanaka
7,
Tomoya Mizunoe
8,
Ikuko Emoto
9,
Kazuhisa Maeda
10,
Kosuke Kawakami
11 and
on behalf of the Collaborative Research in National Hospital Organization Network Pediatric and Perinatal Group
†
1
Medical Data Labo, 289-48 Yamasaki, Naka Ward, Okayama 703-8267, Japan
2
Miyake Ofuku Clinic, 393-1 Ofuku, Minami Ward, Okayama 701-0204, Japan
3
Department of Obstetrics and Gynecology, NHO Okayama Medical Center, 1711-1 Tamasu, Kita Ward, Okayama 701-1192, Japan
4
Department of Obstetrics and Gynecology, NHO Nagasaki Medical Center, 2-1001-1 Kubara, Omura 856-8562, Japan
5
Department of Obstetrics and Gynecology, NHO Saga Hospital, 1-20-1 Hinode, Saga 849-8577, Japan
6
Department of Obstetrics and Gynecology, NHO Mie Chuo Medical Center, 2158-5 Hisaimyojincho, Tsu 514-1101, Japan
7
Department of Obstetrics and Gynecology, NHO Higashihiroshima Medical Center, 513 Saijochojike, Higashihiroshima 739-0041, Japan
8
Department of Obstetrics and Gynecology, NHO Kure Medical Center, 3-1 Aoyama, Kure 737-0023, Japan
9
Department of Obstetrics and Gynecology, NHO Kyoto Medical Center, 1-1 Fukasakumukaihata, Kyoto 612-8555, Japan
10
Department of Obstetrics and Gynecology, NHO Shikoku Medical Center for Children and Adults, 2-1-1 Senyucho, Zentsuji 765-8507, Japan
11
Department of Obstetrics and Gynecology, NHO Kokura Medical Center, 10-1 Harugaoka, Kokuraminami Ward, Kitakyushu 802-8533, Japan
 
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*
Author to whom correspondence should be addressed.
†
All members of the Collaborative Research in National Hospital Organization Network Pediatric and Perinatal Group are listed in the acknowledgments.
J. Clin. Med. 2024, 13(6), 1826; https://doi.org/10.3390/jcm13061826
Submission received: 26 February 2024 / Revised: 18 March 2024 / Accepted: 19 March 2024 / Published: 21 March 2024
(This article belongs to the Topic Artificial Intelligence in Public Health: Current Trends and Future Possibilities)
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Abstract

(1) Background: Although the diagnostic criteria for massive hemorrhage with organ dysfunction, such as disseminated intravascular coagulation associated with delivery, have been empirically established based on clinical findings, strict logic has yet to be used to establish numerical criteria. (2) Methods: A dataset of 107 deliveries with >2000 mL of blood loss, among 13,368 deliveries, was obtained from nine national perinatal centers in Japan between 2020 and 2023. Twenty-three patients had fibrinogen levels <170 mg/dL, which is the initiation of coagulation system failure, according to our previous reports. Three of these patients had hematuria. We used six machine learning methods to identify the borderline criteria dividing the fibrinogen/fibrin/fibrinogen degradation product (FDP) planes, using 15 coagulation fibrinolytic factors. (3) Results: The boundaries of hematuria development on a two-dimensional plane of fibrinogen and FDP were obtained. A positive FDP–fibrinogen/3–60 (mg/dL) value indicates hematuria; otherwise, the case is nonhematuria, as demonstrated by the support vector machine method that seemed the most appropriate. (4) Conclusions: Using artificial intelligence, the borderline criterion was obtained, which divides the fibrinogen/FDP plane for patients with hematuria that could be considered organ dysfunction in massive hemorrhage during delivery; this method appears to be useful.
Keywords: artificial intelligence; delivery; DIC; hemorrhage; machine learning artificial intelligence; delivery; DIC; hemorrhage; machine learning

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MDPI and ACS Style

Miyagi, Y.; Tada, K.; Yasuhi, I.; Tsumura, K.; Maegawa, Y.; Tanaka, N.; Mizunoe, T.; Emoto, I.; Maeda, K.; Kawakami, K.; et al. A Novel Method for Determining Fibrin/Fibrinogen Degradation Products and Fibrinogen Threshold Criteria via Artificial Intelligence in Massive Hemorrhage during Delivery with Hematuria. J. Clin. Med. 2024, 13, 1826. https://doi.org/10.3390/jcm13061826

AMA Style

Miyagi Y, Tada K, Yasuhi I, Tsumura K, Maegawa Y, Tanaka N, Mizunoe T, Emoto I, Maeda K, Kawakami K, et al. A Novel Method for Determining Fibrin/Fibrinogen Degradation Products and Fibrinogen Threshold Criteria via Artificial Intelligence in Massive Hemorrhage during Delivery with Hematuria. Journal of Clinical Medicine. 2024; 13(6):1826. https://doi.org/10.3390/jcm13061826

Chicago/Turabian Style

Miyagi, Yasunari, Katsuhiko Tada, Ichiro Yasuhi, Keisuke Tsumura, Yuka Maegawa, Norifumi Tanaka, Tomoya Mizunoe, Ikuko Emoto, Kazuhisa Maeda, Kosuke Kawakami, and et al. 2024. "A Novel Method for Determining Fibrin/Fibrinogen Degradation Products and Fibrinogen Threshold Criteria via Artificial Intelligence in Massive Hemorrhage during Delivery with Hematuria" Journal of Clinical Medicine 13, no. 6: 1826. https://doi.org/10.3390/jcm13061826

APA Style

Miyagi, Y., Tada, K., Yasuhi, I., Tsumura, K., Maegawa, Y., Tanaka, N., Mizunoe, T., Emoto, I., Maeda, K., Kawakami, K., & on behalf of the Collaborative Research in National Hospital Organization Network Pediatric and Perinatal Group. (2024). A Novel Method for Determining Fibrin/Fibrinogen Degradation Products and Fibrinogen Threshold Criteria via Artificial Intelligence in Massive Hemorrhage during Delivery with Hematuria. Journal of Clinical Medicine, 13(6), 1826. https://doi.org/10.3390/jcm13061826

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