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

Published 16/11/2023

What about point of care coagulation testing (ROTEMÒ/ TEGÒ)?

Rotational Thromboelastometry (ROTEM) and Thromboelastography (TEG) are point-of-care techniques to assess real time coagulation and fibrinolysis in whole blood. The risk of coagulopathy markedly increases with bleeding > 2000 ml, showing the importance of these tests to guide management in MOH. 


  • Rapid, real time, point of care quantitative and qualitative data (available often < 30 minutes) which can be used by clinicians to guide coagulation product transfusion. 

  • Can be repeated serially very easily and compared/ contrasted. 

  • Information on all steps in coagulation including clot growth and fibrinolysis. 

  • Rapid information on hypofibrinogenaemia and when to treat. 

  • Theoretical reduction in bleeding and use of transfusion products, and better outcome, however there is little RCT data to support this, especially in obstetrics.