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Changing hemostatic management in post-partum hemorrhage.
Agnès Rigouzzo1, Pierre-Antoine Froissant1, Nicolas Louvet1
1Anesthesiology Intensive Care Department, Armand Trousseau Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.
American Journal of Hematology
|March 7, 2024
Summary
Rapid point-of-care viscoelastic (VET) assays quickly assess hemostasis in postpartum hemorrhage (PPH). These tests identify low fibrinogen levels, guiding timely treatment to improve patient outcomes.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Critical Care Medicine
Background:
- Postpartum hemorrhage (PPH) requires prompt hemostasis assessment for effective management.
- Fibrinogen levels decrease early in PPH, serving as a key indicator of severity.
- Coagulopathy in PPH necessitates rapid diagnostic tools.
Purpose of the Study:
- To highlight the importance of early hemostasis assessment in PPH.
- To emphasize the role of fibrinogen as an early marker of PPH progression.
- To discuss the utility of point-of-care viscoelastic (VET) assays in managing PPH-related coagulopathy.
Main Methods:
- Review of current evidence on hemostasis assessment in PPH.
- Focus on the application of point-of-care viscoelastic (VET) hemostatic assays.
- Analysis of fibrinogen levels as a critical parameter in PPH.
Main Results:
- VET assays provide rapid assessment of hemostatic disorders during PPH.
- Hypofibrinogenemia is an early and reliable marker of PPH severity.
- VET-guided fibrinogen replacement is supported by evidence.
Conclusions:
- Early and fast hemostasis assessment is crucial for improving outcomes in PPH.
- VET assays are valuable tools for rapid diagnosis and management of PPH coagulopathy.
- Further research is needed to establish thresholds for other coagulation parameters.
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