EDITORIAL
Monitoring transfusion requirements in major obstetric haemorrhage: out with the old and in with the new?

https://doi.org/10.1016/j.ijoa.2011.06.011Get rights and content

Section snippets

Monitoring haemoglobin

Perhaps the most widely used point-of-care device for monitoring Hb is the HemoCue® (HemoCue® Ltd, Sheffield, UK). In parturients, Hb measurements from venous blood or from capillary blood using skin prick sampling have been shown to be accurate and equally so when sampled from the toe or the thumb.4 This is true providing the sampling is performed according to the recommendations of the manufacturer. The disadvantage of the HemoCue®, however, is that it is an intermittent and invasive monitor

Monitoring coagulation

Conventional laboratory tests of coagulation in the context of perioperative bleeding have limited value because of delays from blood sampling to obtaining results and coagulation tests use plasma rather than whole blood. However, monitoring coagulation during MOH is important for several reasons.

Firstly it is helpful to know the aetiology of coagulopathy. In any type of massive haemorrhage coagulopathy develops because of an imbalance between procoagulant, anticoagulant, profibrinolytic and

References (25)

  • R.D. Miller et al.

    A comparison of three methods of hemoglobin monitoring in patients undergoing spine surgery

    Anesth Anal

    (2011)
  • D. Bolliger et al.

    Pathophysiology and treatment of coagulopathy in massive hemorrhage and hemodilution

    Anesthesiology

    (2010)
  • Cited by (7)

    • The effect of dalteparin on thromboelastography in pregnancy: an in vitro study

      2016, International Journal of Obstetric Anesthesia
      Citation Excerpt :

      These studies recommend adjusted reference ranges for the pregnant population (Table 1).15–17 Although TEG was first described in 1948, the lack of consistent reference ranges during pregnancy and the training required to operate the machine have made application to this population difficult.20 Thromboelastography has been used effectively to evaluate coagulation in non-obstetric perioperative or critically-ill patients on LMWH in a variety of settings as an alternative to measuring anti-Xa activity.7,21

    • Major obstetric haemorrhage: Monitoring with thromboelastography, laboratory analyses or both?

      2014, International Journal of Obstetric Anesthesia
      Citation Excerpt :

      These results are supported by other studies reporting changes in TEG/TEM variables during the puerperium.8,9 Few studies have evaluated TEG/TEM in women with PPH10 and the significance of these methods in connection with obstetric haemorrhage is unclear.11–14 The primary aim of this prospective observational study was to describe the results of coagulation testing using TEG and traditional laboratory analyses during major obstetric haemorrhage (MOH) and to compare the findings with results of parturients with normal postpartum blood loss.

    • Thromboelastography

      2012, Revista Colombiana de Anestesiologia
    • New trends in the management of postpartum haemorrhage

      2014, Southern African Journal of Anaesthesia and Analgesia
    View all citing articles on Scopus
    View full text