Case of the Month #45 Major Obstetric Haemorrhage - Part 2

Published 16/11/2023

Take Home Messages

  • Transfusion of red cells and coagulation products should be guided by point of care haemostatic tests (venous Hb/ ROTEM/ TEG) followed by lab tests. 

  • POC coagulation testing (TEG/ ROTEM) allow rapid, real time, quantitative and qualitative data (available often < 30 minutes) which can be used by clinicians to guide coagulation product transfusion. 

  • Fibrinogen concentrate use/replacement of fibrinogen should be considered early in obstetric bleeding (especially in specific circumstances such as placental abruption/ amniotic fluid embolus). 

  • Specific measures for MOH include pharmacological, mechanical, surgical and radiological. 

  • Post event debriefing is essential for both the patient/ birth partner and staff involved.