Point-of-care viscoelastic tests in the management of obstetric hemorrhage
Abstract
Obstetric hemorrhage remains the leading cause of maternal morbidity and mortality worldwide. Thromboelastography and rotational thromboelastometry are laboratory methods of assessing the kinetics of blood clot formation through real-time measurement of viscoelastic clot strength and may aid in management of severe hemorrhage. Although first described more than 70 years ago, viscoelastic testing devices are now available that allow for rapid point-of-care use of this technology to aid in real-time management of blood product replacement in cases of severe hemorrhage. These devices can be used to visually estimate multiple facets of hemostasis-coagulation, platelet function, and fibrinolysis-within 10-20 minutes. They have been used successfully in cardiac surgery, trauma, and liver transplantation and have potential for use in management of obstetric hemorrhage. Goals with their use include targeted transfusion of blood and its components for specific coagulation deficiencies. To date, however, published experiences with the use of these viscoelastic tests for obstetric hemorrhage have been limited. Because of the increasing use of the point-of-care tests by anesthesiologists, surgeons, and intensivists, the purpose of this report is to familiarize obstetricians with the technology involved and its use in severe hemorrhage complicating pregnancy.
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TEG/ROTEM results are typically available in 15-20 minutes, which is much faster than coagulation studies.
“TEG/ROTEM results are typically available in 15–20 minutes, which is much faster than coagulation studies (88).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [88]
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- Authors
- Nelson, D. B., Ogunkua, O., & Cunningham, F. G.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Venue
- Obstetrics & Gynecology
- Published
- 2022-02-02
- Volume
- 139
- Issue
- 3
- Pages
- 463-472
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W4210272329
- Cited by
- 13
- References
- 35
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 5 · 2022: 4
- FWCI
- 2.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
- Health Sciences › Medicine › Biochemistry › Blood transfusion and management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Keywords
- obstetric hemorrhage, thromboelastography, rotational thromboelastometry, coagulation monitoring, hemostasis, fibrinolysis, platelet function, maternal morbidity and mortality
- MeSH terms
- Point-of-Care Testing, Female, Postpartum Hemorrhage, Humans, Pregnancy, Thrombelastography
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