Case report
Management of a postpartum coagulopathy using thrombelastography

https://doi.org/10.1016/S0952-8180(97)00026-3Get rights and content

Abstract

Thrombelastography (TEG), which evaluates the elastic properties of whole blood and provides a global assessment of hemostatic function, is useful in managing peripartum coagulopathy. A case of severe bleeding after vaginal delivery, in which TEG was used successfully to manage hemostatic defects, is presented.

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Cited by (41)

  • Study of acute hemocoagulation changes in a porcine endotoxemic shock model using thrombelastography

    2015, Translational Research
    Citation Excerpt :

    Simpler techniques to assess coagulation abnormalities at the bedside are needed (point-of-care [POC]). Thrombelastography (TEG) is currently being used to manage coagulation abnormalities in obstetric patients13,14 and to monitor trauma patients, patients undergoing cardiac surgery, and patients undergoing liver transplantation.15-20 Recently, TEG has also been used to characterize endotoxin-induced coagulopathy in vitro or in animal models.21-23

  • How i treat postpartum hemorrhage

    2015, Blood
    Citation Excerpt :

    They have been used to demonstrate the hypercoagulable state of pregnancy27-29 and the resolution to nonpregnant values in the puerperium.30,31 There are numerous case reports of the use of TEG and ROTEM to guide replacement of blood components in the management of PPH32,33 and studies have confirmed a reduction in blood loss and associated transfusion of blood products with the use of these tests in other settings.34-36 A Cochrane systematic review of 9 randomized controlled trials (RCTs) (involving 776 bleeding patients) concluded that TEG or ROTEM significantly reduced blood loss, but there was no impact on mortality, amount of blood transfused, or length of stay in hospital and intensive care units.37

  • Multiple electrode aggregometry in severe obstetric haemorrhage

    2014, International Journal of Obstetric Anesthesia
  • Haemostatic monitoring during postpartum haemorrhage and implications for management

    2012, British Journal of Anaesthesia
    Citation Excerpt :

    Evidence supporting the value of thrombelastography for treatment of acute obstetric haemorrhage has been available in German-language publications for more than 30 yr.89 Elsewhere, case-studies have reported successful use of TEG®/ROTEM® to guide intraoperative haemostatic treatment.90–97 In addition, two prospective trials have shown the potential benefit of using viscoelastic testing for monitoring coagulation defects and guiding therapy in the labour ward.

  • The use of thromboelastography for the peripartum management of a patient with platelet storage pool disorder

    2011, International Journal of Obstetric Anesthesia
    Citation Excerpt :

    TEG is clinically useful in cardiac surgery, liver transplantation, general, urological, and pediatric surgery.12–14 The use of TEG has been described for the management of postpartum hemorrhage in a patient with Glanzmann’s thrombasthenia.15,16 To our knowledge, this is the first case report of the use of TEG in PSPD to aid in risk assessment before neuraxial technique and guide transfusion requirements.

  • Anesthesia in the Pregnant Patient with Hematologic Disorders

    2011, Hematology/Oncology Clinics of North America
    Citation Excerpt :

    TEG was first established in 1941 and popularized for the use of coagulation monitoring during cardiac and liver transplant surgeries.45 TEG has been used to demonstrate the hypercoagulable state of normal pregnancy as well as the impaired coagulation that develops in the setting of severe preeclampsia.46,47 A significant correlation was found between the maximum amplitude (an indicator of clot strength) and platelet count in healthy term parturients.48

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