Abstract:
:The haemostatic management of major obstetric haemorrhage remains challenging, and current published guidance relies heavily on experience from the non-pregnant population and expert opinion. In recent years, an interest in the implications of relative hypofibrinogenaemia, point-of-care monitoring of coagulation abnormalities, and the potential to give goal-directed therapy to correct coagulopathies, have created the possibility of significantly challenging and changing guidance. There is evidence that the haemostatic impairment in the pregnant population is different from trauma-induced bleeding, and the type and rate of onset of coagulopathies differ depending on the underlying cause. This review examines areas such as possible intervention points, describes evidence for over-transfusion of fresh frozen plasma in some situations and challenges conventional thinking on formulaic management. It also examines the rationale for other therapeutic options, including fibrinogen concentrate and tranexamic acid.
journal_name
Anaesthesiajournal_title
Anaesthesiaauthors
Collis RE,Collins PWdoi
10.1111/anae.12913subject
Has Abstractpub_date
2015-01-01 00:00:00pages
78-86, e27-8eissn
0003-2409issn
1365-2044journal_volume
70 Suppl 1pub_type
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