ROTEM pilot study: A new method for measuring coagulation problems in women during labor.

Post partum hemorrhage (PPH) is the main cause of maternal death worldwide and the main cause of severe maternal morbidity in the Netherlands. The course of PPH is unpredictable. Timely recognition and prompt intervention are crucial for successful management. Crucial prognostic factors for the severity of PPH are a delay in obstetric management and development of secondary coagulopathy. In the usual care however, results of laboratory tests may take more than 60 minutes and are non specific. Therefore only in severe cases clotting tests are done and the regular management consists of transfusion of red blood cells and fresh frozen plasma. Evaluation of the efficacy of current treatment strategies is however lacking, also because of inadequate monitoring possibilities. In cardiac and liver surgery, the use of tromboelastometry (ROTEM) is a cost effective strategy leading to more selective substitution management and less blood transfusions.

In cardiac and liver surgery, the use of tromboelastometry (ROTEM) is a cost effective strategy leading to more selective substitution management and less blood transfusions. The method has not yet been validated for pregnant women nor are there normal values for ROTEM in pregnancy.

Gain permission from medical and ethical commision Maastricht, start trial 01-11-2010 in Maastricht and in the other centres before 01-12-2010.

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