Early viscoelastometric guided fibrinogen replacement combined with escalation of clinical care reduces progression in postpartum haemorrhage: a comparison of outcomes from two prospective observational studies
Authors' conclusion
These results suggest that use of VHA as part of an early bundle of PPH care targeting fibrinogen ≤2 g/L with fibrinogen concentrate reduces PPH progression.
Study context
- Population
- Women with PPH in the same institution
- Exposure
- Study One vs Study Two
- Outcome
- PPH progression: measured blood loss ≥2500 mL, ≥4 units red blood cell (RBC) transfusion, FFP transfusion, ≥8 units of any blood product
Methodological detailsbefore-after, single-centre, before and after practice change, All blood samples taken near 1000 mL qualitative blood loss (QBL) in both studies
- Before-after
- Single-centre
- Before and after practice change
- All blood samples taken near 1000 mL QBL in both studies
Main finding
As reported in the abstract
- Rates all reduced in Study Two vs Study One
- P < 0.01
Observational data: associations, not effects.
Further findings
≥4 units RBC transfusion, women with fibrinogen ≤2 g/L at study entry (subgroup)
P = 0.0007
Original publication
Early viscoelastometric guided fibrinogen replacement combined with escalation of clinical care reduces progression in postpartum haemorrhage: a comparison of outcomes from two prospective observational studies. Int J Obstet Anesth. Published 30 April 2024. doi:10.
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