Standard haemostatic tests following major obstetric haemorrhage

Lloyd, L. de; Bovington, R.; Kaye, A.; Collis, Rachel; Rayment, Rachel; Sanders, Julia; Rees, Alyson; Collins, Peter William

doi:10.1016/j.ijoa.2010.12.002

Cited by 182 publications

(183 citation statements)

References 31 publications

Supporting

Mentioning

166

Contrasting

Unclassified

Order By: Relevance

“…85 Additional analysis of 456 patients with PPH .1500 mL reported fibrinogen levels correlated with blood loss. 86 Further studies in PPH report that fibrinogen concentrate therapy is important in patients with hypofibrinogenemia. 6 Initial fibrinogen levels below 2 g/L in women with PPH are associated with more severe hemorrhage.…”

Section: Obstetric Hemorrhagementioning

confidence: 99%

How I use fibrinogen replacement therapy in acquired bleeding

Levy

Goodnough

2015

Blood

141

102

View full text Add to dashboard Cite

Fibrinogen is a critical protein for hemostasis and clot formation. However, transfusion guidelines have variable recommendations for maintaining fibrinogen levels in bleeding patients. An increasing number of studies support the practice of fibrinogen replacement therapy for acquired coagulopathies, and additional studies are underway. Fibrinogen therapy can be administered with cryoprecipitate or fibrinogen concentrates, and clinical practice varies according to their availability and licensing status. Fibrinogen concentrate therapy has been studied in animal models and clinical trials and supports the critical role of fibrinogen repletion in bleeding patients. Point-of-care testing will have an important role in guiding fibrinogen replacement for hemostatic therapy in clinical settings such as cardiovascular surgery, postpartum hemorrhage, and trauma. Fibrinogen therapy is an important component of a multimodal strategy for the treatment of coagulopathic bleeding.

show abstract

Section: Obstetric Hemorrhagementioning

confidence: 99%

How I use fibrinogen replacement therapy in acquired bleeding

Levy

Goodnough

2015

Blood

141

102

View full text Add to dashboard Cite

show abstract

“…Our patient had profound hypofibrinogenemia, now recognized as an important early coagulation abnormality associated with MOH. [24][25][26] Fibrinogen is consumed in widespread clot development and enhanced fibrinolytic factors accelerate breakdown of fibrin and fibrinogen. The resulting degradation products interfere with platelet activation and fibrin creation and hyperfibrinolysis occurs, whereby fibrinolytic activity is greater than fibrin formation, leading to severely diminished clot strength.…”

Section: Coagulopathymentioning

confidence: 99%

“…A review of 18 501 pregnancies identified 456 cases with blood loss exceeding 1500 mL; PT did not correlate with the APTT or volume of blood loss. 26 Due to the distance between our delivery suite and the pathology laboratories, the introduction of near patient tests, several years ago, was essential. Thromboelastography (TEG) and thromboelastometry (ROTEM) are capable of providing a useful assessment of the coagulation status within minutes (Figure 1).…”

Section: Point-of-care Testsmentioning

confidence: 99%

How I treat postpartum hemorrhage

Pavord

Maybury

2015

Blood

View full text Add to dashboard Cite

Worldwide, ∼800 women die every day from preventable causes related to pregnancy or childbirth. The single most common cause is severe bleeding, which can kill a healthy woman within hours if care is substandard or delayed. Improved antenatal practices have led to the early identification of at-risk women and modern technology and new techniques have enabled effective management strategies so that now, in the western world, most of the morbidity and mortality arises from those cases which occur unexpectedly and could not have been predicted. Prompt and effective management and multidisciplinary involvement is paramount to save the lives of these women. We use a case report to illustrate and discuss the main elements of management of this condition.

show abstract

“…It is recognized that fibrinogen falls to critically low levels earlier than other coagulation factors during PPH and other situations of massive hemorrhage. 7,8 The appropriate fibrinogen level during massive hemorrhage is debated, and guidelines offer differing recommendations. [9][10][11][12] Current evidence derives from trauma-related bleeding, and it may not be appropriate to extrapolate these data to PPH, because the fibrinogen level at term is 4 to 6 g/L compared with 1.5 to 4 g/L in the general population.…”

Section: Introductionmentioning

confidence: 99%