Fibrin-based clot formation as an early and rapid biomarker for progression of postpartum hemorrhage: a prospective study.

Collins PW, Lilley G, Bruynseels D, et al.
Blood 2014;124:1727-1736.
NATA Rating :
Review by : S. Kozek-Langenecker
NATA Review

In a prospective, observational study, an interdisciplinary group of authors found FIBTEM to predict progression to severe postpartum haemorrhage (PPH). FIBTEM was a better and faster biomarker for severe bleeds than fibrinogen levels, PT or aPTT. Published in Blood, this paper adds significantly to the increasing body of evidence supporting point-of-care coagulation monitoring in the acute setting.

However, low FIBTEM should not only alert clinicians about potential PPH progression but rather trigger rational therapeutic interventions, e.g. rapid and sufficient correction of the fibrinogen deficit. European Society of Anaesthesiology guidelines point to this direction and a PPH app based on clinicians’ experiences may be helpful, but randomised clinical trials are warranted.

– Sibylle Kozek-Langenecker

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