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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
PubMed

Early and fast assessment of hemostasis during postpartum hemorrhage (PPH) is essential to allow early characterization of coagulopathy, estimate bleeding severity and improve outcome. During PPH, fibrinogen decrease occurs earlier than other coagulation factors deficiency and hypofibrinogenemia is an early marker of PPH severity of progression. With good evidence in the context of PPH, point-of-care viscoelastic (VET) hemostatic assays have been shown to provide rapid assessment of hemostatic disorders, low fibrinogen levels, and allow VET-guided fibrinogen replacement. Further studies are needed to define the thresholds for the other coagulation parameters.

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