Application of the rotational thromboelastography/thromboelastometry for assessment of massive obstetric blood loss in a high risk group
https://doi.org/10.17749/2313-7347.2020.14.1.94-101
Abstract
Here, we discuss blood management upon a risk of massive obstetric hemorrhage by describing a clinical case of female patient with obstetric complications of pregnancy such as severe preeclampsia and chronic placental insufficiency with fetal malnutrition examined by using thromboelastometry to assess a risk of developing massive obstetric hemorrhage. A rotational thromboelas-tography/thromboelastometry technology as well as available publications related to using it in obstetrics are outlined.
About the Authors
D. R. Eremeeva
V.F. Snegirev Maternity Hospital № 6
Russian Federation
Russian Federation
Dina R. Eremeeva - MD, PhD, Deputy of Head Physician for outpatient work, V.F. Snegirev Maternity Hospital № 6.
5 Mayakovskogo St., Saint Petersburg 192014
M. S. Zainulina
V.F. Snegirev Maternity Hospital № 6; I.P. Pavlov First Saint Petersburg State Medical University, Health Ministry of Russian Federation
Russian Federation
Russian Federation
Marina S. Zainulina - MD, Dr Sci Med, Head Physician, V.F. Snegirev MH № 6; Professor, Department of Obstetrics, Gynecology and Reproductive Medicine, I.P. Pavlov First Saint-Petersburg SMU, Scopus Author ID: 37076359000, Researcher ID: B-5746-2018.
5 Mayakovskogo St., Saint Petersburg 192014; 6/8 Lev Tolstoy St., Saint Petersburg 197022
References
1. Trends in maternal mortality: 1990 to 2015. Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. World Health Organization, 2015. 98 р. Available at: https://www.unfpa.org/sites/default/files/pub-pdf/9789241565141_eng.pdf. (Accessed: 27.08.2019).
2. Zainulina M.S., Eremeeva D.R., Krivonos M.I. Maternal mortality and maternal «near miss»: are the current bleeding prevention algorithms working? [Materinskaya smertnost’ i «near miss»: rabotayut li algo-ritmy profilaktiki krovotechenij?]. Akusherstvo, ginekologiya irepro-duktsiya. 2018;12(1):62—72. (In Russ.). DOI: 10.17749/2313-7347.2018.12.1.062-072.
3. Huissoud C., Carrabin N., Audibert F. et al. Bedside assessment of fibrinogen level in postpartum haemorrhage by thrombelastometry. BJOG. 2009;116(8):1097—102 DOI: 10.1111/j.1471-0528.2009.02187.x.
4. Grinevich T.N., Naumov A.V., Lelevich S.V. Rotary thromboelastometry (ROTEM). [Rotacionnaya tromboelastometriya (ROTEM)]. Zhurnal Grodnenskogo gosudarstvennogo medicinskogo universiteta. 2010;(1):7-9. (In Russ.).
5. Avdushkina L.A., Vavilova T.V., Zybina N.N. Thrombelastography/ thromboelastometry in the estimation of hemostasis system: the past and the present. Reference ranges. [Metod tromboelastografii/ tromboelastometrii v ocenke sistemy gemostaza: proshloe i nastoyashchee. Referentnye intervaly]. Kliniko-laboratornyj konsilium. 2009;5(30) 26-33. (In Russ.).
6. Calatzis A., Haas S., G'dje O. et al. Thrombelastographic coagulation monitoring during cardiovascular surgery with the ROTEG coagulation analyzer. In: Management of bleeding in cardiovascular surgery. Ed. R. Pifare. Philadelphia: Hanley & Belfus, 2000. 215-26.
7. Calatzis A., Fritzsche P. ROTEG Coagulation Analyzer: ein neues System zur intraoperativen Bedside-Gerinnungs diagnostik. Der Anaesthesist. 1995;44(2):491.
8. Schobersberger W., Fries D., Mittermayr M. et al. Changes of biochemical markers and functional tests for clot formation during long-haul flights. Thromb Res. 2002;108(1):19-24. DOI: 10.1016/s0049-3848(02)00347-x.
9. Barabas E., Szell E., Bajusz S. Screening for fibrinolysis inhibitory effect of synthetic thrombin inhibitors. Blood Coagul Fibrinolysis. 1993;4(2):243-8. DOI: 10.1097/00001721-199304000-00005.
10. Grosse H., Lobbes W., Frambach M. et al. The use of high-dose aprotinin in liver transplantation: the influence on fibrinolysis and blood loss. Thromb Res. 1991;63(3):287-97. DOI: 10.1016/0049-3848(91)90132-G.
11. Ramsay M., Randall H.B., Burton E.C. Intravascular thrombosis and thromboembolism during liver transplantation: antifibrinolytic therapy implicated? Liver Transpl. 2004;10(2):310-4. DOI: 10.1002/lt.20064.
12. Klein S.M., laughter T.F., Vail P.T. et al. Thromboelastography as a perioperative measure of anticoagulation resulting from low molecular weight heparin: a comparison with anti-Xa concentrations. Anesth Analg. 2000;91(5):1091-5. DOI: 10.1097/00000539-200011000-00009.
13. Orlikowski C.E., Rocke D.A., Murray W.B., Gouws E. Thrombelastogra-phy changes in preeclampsia and eclampsia. Br J Anaesth. 1996;77(2):157-61. DOI: 10.1093/bja/77.2.157.
14. Hayashi T., Tanaka I., Shima M. et al. Unresponsiveness to factor VIII inhibitor bypassing agents during haemostatic treatment for life-threatening massive bleeding in a patient with haemophilia A and a high responding inhibitor. Haemophilia. 2004;10(4):397-400. DOI: 10.1111/j.1365-2516.2004.00924.x.
15. Yoshioka A., K. Nishio K., Shima M. Thrombelastgram as a hemostatic monitor during recombinant factor VIIa treatment in hemophilia A patients with inhibitor to factor VIII. Haemostasis. 1996;26(Suppl 1):139-42. DOI: 10.1159/000217256.
16. Kozek-Langenecker S.A., Afshari A., Albaladejo P. et al. Management of severe perioperative bleeding Guidelines from the European Society of Anaesthesiology. Eur JAnaesthesiol. 2013;30(6):270-382. DOI: 10.1097/EJA.0b013e32835f4d5b.
17. Management of Postpartum Haemorrhage (PPH). The Royal Australian and New Zealand College of Obstetricians and Gynecologists, 2017.
18. p. Available at: https://ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Statement%20and%20guidelines/Clinical-Obstetrics/Management-of-Postpartum-Haemor-rhage-(C-Obs-43)-Review-July-2017.pdf?ext=.pdf. (Accessed: 27.08.2019).
19. Solomon C., Collis R.E., Collins P.W. Haemostatic monitoring during postpartum haemorrhage and implications for management. Br J Anaesth. 2012;109(6):851-63. DOI: 10.1093/bja/aes361.
20. De Lange N.M., Lance M.D., de Groot R. et al. Obstetric hemorrhage and coagulation: an update. Thromboelastography, thromboelastometry, and conventional coagulation tests in the diagnosis and prediction of postpartum hemorrhage. Obstet Gynecol Surv. 2012;67(7):426-35. DOI: 10.1097/OGX.0b013e3182605861.
21. Collins N.F., Bloor M., McDonnell N.J. Hyperfibrinolysis diagnosed by rotational thromboelastometry in a case of suspected amniotic fluid embolism. Int J Obstet Anesth. 2013;22(1):71-6. DOI: 10.1016/j.ijoa.2012.09.008.
Review
For citations:
Eremeeva D.R., Zainulina M.S. Application of the rotational thromboelastography/thromboelastometry for assessment of massive obstetric blood loss in a high risk group. Obstetrics, Gynecology and Reproduction. 2020;14(1):94-101. (In Russ.) https://doi.org/10.17749/2313-7347.2020.14.1.94-101
Views: 810
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Email this article 
