Study reference

Study characteristics

Patient characteristics ²

Intervention (I)

Comparison / control (C) ³

Follow-up

Outcome measures and effect size ⁴

Comments

Jokinen, 2023

Type of study: Randomized, single-blind, controlled pilot study

Setting and country:

Participants recruited between 2016 up to 2019 from Tampere University Hospital, Finland.

Funding and conflicts of interest:

Funded by the Orion Research Foundation and Tampere University Hospital.

Inclusion criteria:

Parturient >18 years with severe postpartum haemorrhage (PPH) of > 1500 ml

Exclusion criteria:

• Bleeding disorders
• Refusal of allogeneic blood products.

N total at baseline:

Intervention: 30

Control: 30

Important prognostic factors²:

age ± range:

I: 32.8 (24-43)

C: 31.5 (24-43)

P=0.341

BMI ± SD:

I: 32.0 (6.42)

C: 29.8 (6.52)

P=0.208

Blood loss before entering theatre (ml), median (IQR):

I: 600 (2000)

C: 1500 (1500)

P=0.118

Groups comparable at baseline?

Yes

Describe intervention (treatment/procedure/test):

ROTEM-guided protocol

In detail: ROTEM Extem + Fibtem with blood count, fibrinogen, aPTT, INR and blood gas analysis

Describe  control (treatment/procedure/test):

Standard care using clinical judgement and conventional coagulation testing

In detail: Blood count, fibrinogen, aPTT, INR, blood gas analysis

Length of follow-up:

12-24 h after treatment.

Loss-to-follow-up/incomplete outcome data:

Intervention: 3/30

N (%) 27 (90%)

Reasons (describe)

• Considered ineligible afterwards (abortion, n=1);
• No confirmational consent (n=2)

Control: 3/30

N (%) 27 (90%)

Reasons (describe):

• Considered ineligible afterwards (abortion, n=1);
• Could not give consent (language barrier, n=1);
• Critical data missing (n=1).

Outcome measures and effect size (include 95%CI and p-value if available):

Median (25^th – 75^th %) amount of transfused Red Blood Cells units:

I: 2 (1-4)

C: 3 (2-4)

P=0.399

Number (%) of subjects transfused:

I: 21 (77.8%)

C: 23 (85.2)

P=0.484

Median (25^th – 75^th %) amount of OctaplasLG® units:

I: 0 (0-0)

C: 0 (0-2)

P=0.030

Number (%) of subjects transfused OctaplasLG® units only:

I: 5 (18.5%)

C: 12 (44.4%)

P=0.040

Sulprostone infusion, n (%):

I: 2 (7.4%)

C: 8 (29.6%)

P=0.036

Total estimated blood loss:

I: 2500 (2100-3000)

C: 3000 (2200 – 3100)

P=0.033

Words from author:

‘’ROTEM-guided treatment of postpartum haemorrhage could have a plasma-sparing effect but possibly only

a small reduction in total blood loss.’’

‘Use of ROTEM® thromboelastometry might decrease administration

of plasma by avoiding unnecessary OctaplasLG®

transfusions.’

“Subjects had a mean RBC transfusion amount of 2.6 units

(SD, 1.67), which is less than our assumed amount; thus the

sample size was insufficient.”

McNamara, 2019

Type of study:

Retrospective observational study

Setting and country:

Liverpool Women’s Hospital, United Kingdom.

Funding and conflicts of interest:

One of the authors has received travel expenses and honoraria from

Tem International/Werfen for talks given in relation to

viscoelastometric testing. Another author has received travel expenses

from Werfen to attend a meeting. No other conflicts of

interest.

Inclusion criteria:

• Women with major obstetric haemorrhage (≥ 1500 ml with ongoing bleeding or signs of clinical shock)  and coagulopathy (defined as a ROTEM FibTEM A5 value of ≤ 12 mm).

Exclusion criteria:

• Not mentioned

N total at baseline:

Intervention: 203

Control: 52

Groups comparable at baseline?

No information provided

Describe intervention (treatment/procedure/test):

ROTEM algoritm, with fibrinogen concentrate given to those with a FibTEM A5 value of <7 mm, or 7-12 mm with ongoing or high risk of haemorrhage.

Describe  control (treatment/procedure/test):

Standard practice: shock pack at the onset of major obstetric heamorrhage. Containing four units of fresh frozen plasma, four units of packed red blood cells, and one dose of platelets.

Length of follow-up:

I: women who met criteria between 1 July 2012 and 31 July 2016

C: women who met criteria between 1 April 2011 and 31 March 2012.

Loss-to-follow-up/incomplete outcome data:

In both groups there was no loss to follow up or incomplete outcome data.

Outcome measures and effect size (include 95%CI and p-value if available):

Intensive Care Unit admission (number (proportion)):

I: 4 (1.9%)

C: 4 (7.7%)

P = 0.057

Hysterectomy (number (proportion)):

I: 16 (7.9%)

C: 7 (13.5%)

P=0.274

Total number of blood products administered (median ((IQR [range])):

I: 3 (2-5[0-26])

C: 6 (3-12 [0-32])

P= <0.0001

Red blood cells; units: median (IQR [range]:

I: 3 (2-4 [0-14])

C: 3 (2-5 [0-14])

P=0.158

Fresh frozen plasma; units: median (IQR [range]:

I: o (0-0 [0-14])

C: 4 (0-4 [0-12])

P < 0.001

Cryoprecipitate; units: median (IQR [range]:

I: 0 (0-0 [0-7])

C: 0 (0-2 [0-7])

P <0.001

Platelets; units: median (IQR [range]:

I: 0 (0-0 [0-4])

C: 0 (0-1 [0-6])

P=0.007

Total volume of blood products administered in L (median (IQR [range])):

I: 0.8 (0.6 – 1.9 [0-7.6])

C: 1.7 (0.8 – 3.1 [0-8.4])

P=0.0007

Maternal death:

I: 0

C: 0

Difference in sample size

Authors conclusion:

‘’we demonstrated improved clinical

outcomes for following by the selective use of fibrinogen

concentrate to treat coagulopathy identified using ROTEM (…). Use of an

algorithm with point-of-care testing allowed individualised

treatment, focusing on fibrinogen as one of the main factors

in obstetric haemorrhage, while avoiding the use of

unnecessary blood products with the associated morbidity

and mortality.’’

Snegovskikh, 2018

Type of study:

retrospective cohort

Setting and country:

Delivery room, postoperative recovery area, IC unit, Yale-new Haven Hospital in New Haven, Connecticut, United States.

Funding and conflicts of interest:

Not mentioned

Inclusion criteria:

• Severe PPH (blood loss 1500 mL or greater)

Exclusion criteria:

Not mentioned

N total at baseline:

Intervention: 28

Control: 58

Important prognostic factors²:

age ± SD:

I: 35.0 ± 6.2

C: 33.3 ± 6.6

P=0.27

Body mass index ± SD:

I: 31.1 ± 5.9

C: 23.4 ± 8.0

P=0.43

Presence of gyn/oncologist:

I: 5 (17.9%)

C: 35 (60.3%)

P= < 0.001

General anasthesia:

I: 8 (28.6%)

C: 32 (55.2%)

P=0.04

Groups comparable at baseline?

No

Describe intervention (treatment/procedure/test):

Blood product transfusion was guided by Point-of-Care Viscoelastic Testing (PCVT) performed using a ROTEM delta device.

Between May 1, 2014 – July 31, 2015

Describe  control (treatment/procedure/test):

Blood product transfusion was guided by standardized massive transfusion protocol.

Between Januari 1, 2011 – April 30, 2014 + those after the date if personnel trained in PCVT were not immediately available.

Length of follow-up:

Not applicable, duration of birth

There was no loss-to-follow-up/incomplete outcome data.

Outcome measures and effect size (include 95%CI and p-value if available):

Amount of red blood cells (units) transfused, n(%)

P < 0.001

0 units

I: 11 (39.3%)

C:3 (5.2%)

1 unit

I: 7 (25.0%)

C: 3 (5.2%)

≥2 units

I: 10 (35.7%)

C: 52 (89.6%)

Amount of fresh frozen plasma (units) transfused, n(%)

P < 0.001

0 units

I: 25 (89.3%)

C: 16 (27.6%)

≥1 unit

I: 3 (10.7%)

C: 42 (72.4%)

Amount of crypoprecipitate (units) transfused, n(%)

P = 0.78

0 units

I: 22 (87.6%)

C: 47 (81%)

≥ 5 units

I: 6 (21.4%)

C: 11 (19%)

Amount of platelets (units) transfused, n(%)

P < 0.001

0 units

I: 28 (100%)

C: 32 (55.2%)

≥ 5 units

I: 0 (0%)

C: 26 (44.8%)

Estimated blood loss (Median [IQR])

I: 2000 [1600-2500]

C: 3000 [2000-4000]

P < 0.001

Incidence of puerperal hysterectomy:

I: 7/28 (25%)

C: 31/58 (53.5%)

P = 0.013

Postoperative IC admission:

I: 1/28 (3.6%)

C: 25/58 (43.1%)

P < 0.0001

Length of postpartum hospitalization

I: 4 [3-4]

C: 5 [4-6]

P=0.001

Authors conclusion:

PCVT-based goal-directed blood product replacement management was associated with substantial benefits over a standardized massive transfusion protocol both in terms of patient outcomes and cost of care.

The ability to demonstrate the

absence of clinically significant coagulopathy in real-time during surgery

allowed us to avoid unnecessary blood product transfusion. Not

only did patients managed with PCVT-based goal-directed therapy require

less blood product replacement, but this strategy was also associated

with improved patient outcomes and reduced cost of care.

We have shown that patients in the

PCVT cohort received significantly lower volumes of transfused blood

products, underwent fewer hysterectomies, were less frequently admitted

to the ICU, and had shorter hospitalizations as compared with those

managed using the more traditional empiric protocol. Not surprisingly,

direct hospitalization cost was also significantly reduced in these

patients.

Lumbreras-Marquez (2022)

Type of study: Single center randomized controlled trial (RCT)

Setting and country:

Brigham and Women’s Hospital. Boston, US.

Funding and conflicts of interest:

The study was funded by an unrestricted donation from the Hess

Foundation, which had no role in the study’s design, execution, analysis,

or manuscript preparation.

Michaela K. Farber has been a member of the Octapharma Advisory

Board since October 2021 and has received compensation for a

1 h session to date. All other authors declare that they have no known

competing financial interests or personal relationships that could

have influenced the work reported in this manuscript.

Inclusion criteria:

Women age 18−50 years with a singleton or multiple pregnancy admitted for delivery with ≥1 major or 2 moderate PPH risk factors were recruited

(see details in article).

Randomization was reserved for only those enrollees who experienced PPH.

Exclusion criteria:

• A known coagulation defect before delivery (see details in article).
• Being on anticoagulation,
• refusing to accept transfusion (e.g., Jehovah’s Witness) were excluded.

N total at baseline:

Intervention: 23

Control: 26

Important prognostic factors²:

Based on a sample size of 26 patients per group, an absolute standardized difference greater than 0.38 was considered to indicate greater difference than would be expected by chance.

Age, mean ± range (min, max):

I: 36 ± 5 (26, 46)

C: 36 ± 5 (26, 46)

Standardized difference: -0.051

BMI, mean  ± SD (min, max):

I: 31 ± 6 (21, 46)

C: 34 ± 9 (21, 63)

Standardized difference: -0.317

Gravidity, median (Q1, Q3) [min,max]

I: 4 (2,5) [2,9]

C: 3 (2,4) [1,8]

Standardized difference: 0.409

Race, n (%)

White:

I: 13 (56.5)

C: 17 (70.8)

Black:

I: 5 (21.7)

C: 5 (20.8)

Asian:

I: 4 (17.4)

C:2 (8.3)

Hispanic or Latino:
I:1 (4.3)

C:0 (0)

Standardized difference: 0.429

Ethnicity, n (%):

Hispanic:

I: 3 (13.6)

C: 4 (18.2)

Non-Hispanic

I: 19 (86.4)

C:18 (81.8)

Standardized difference: -0.125

Groups comparable at baseline?

No. Control participants had lower gravidity, a different distribution of percentage of race (control more white), and a different distribution in percentage of anesthesia (control more combined spinal epidural).

Describe intervention (treatment/procedure/test):

Standard of care plus ROTEM testing with results disclosed to the

care team)

Describe  control (treatment/procedure/test):

Standard of care plus ROTEM testing with

results undisclosed)

Length of follow-up:

Recruitment period of 3.5-years.

Loss-to-follow-up/incomplete outcome data:

No loss to follow-up

Outcome measures and effect size (include 95%CI and p-value if available):

All variables are from the intention-to-treat analysis.

Blood loss, EBL of QBL (mL), median (Q1, Q3) [min,max]

I: 2100 (1800, 2844) [ 1200, 10.000]

C: 2000 (1500, 2600) [1000, 4743]

P=0.228

Total RBC transfused, median (Q1, Q3) [min, max]:

I: 1 (0,4) [0,16]

C: 2 (1,3) [0,9]

P=0.594

Total fresh frozen plasma transfused, median (Q1, Q3) [min, max]:

I: 0 (0,3) [0,9]

C: 0 (0,2) [0,9]

P=0.972

Total platelets transfused, median (Q1, Q3) [min, max]:

I: 0 (0,0) [0,4]

C: 0 (0,0) [0,2]

P=0.307

Total cryoprecipitate transfused, median (Q1, Q3) [min, max]:

I: 0 (0,0) [0,3]

C: 0 (0,0) [0,2]

P=0.846

Coagulopathy, n(%)

I: 1 (4.3%)

C: 5 (19.2%)

P = 0.194

ICU admission, n(%):

I: 2 (8.7%)

C: 1 (3.8%)

P = 0.594

Hysterectomy performed, n (%):

I: 13 (56.5)
C: 14 (53.8)

P=0.851

Length of stay (days), median (Q1, Q3) [min,max]

I: 4 (4,9) [3, 38]

C: 4 (4,5) [2,20]

P=0.258

Randomization without stratification.

PPH is defined as blood loss ≥ 1000 ml, all other studies used ≥ 1500 ml.

Small sample size. They based their statistical absolute standardized difference on 26 participants per arm. So the statistical values for baseline characteristics are not trustworthy.

Studie was stopped earlier:

“With slower than anticipated accrual

rate of eligible participant randomization over the study period,

potential changes in contemporary management of PPH evolved

based on published cohort studies [13−16], and exposure to

ROTEM, even in cases in which ROTEM data was not available.

Therefore, the trial was stopped after 49 participants were randomized;

23 participants were allocated to the intervention group, and

26 to the control group”

”Under these real-world circumstances, this RCT did

not identify a clinically important difference in the number of total

blood products transfused between the intervention and control

groups which contrasts with prior observational studies”’

Per protocol: Clinicians

caring for participants randomized to the intervention group

were provided ROTEM results and a management algorithm to

guide their transfusion choices, but adherence to the algorithm was

not mandated in our study and was inconsistent.

Study reference

(first author, publication year)

Was the allocation sequence adequately generated?

Definitely yes

Probably yes

Probably no

Definitely no

Was the allocation adequately concealed?

Definitely yes

Probably yes

Probably no

Definitely no

Blinding: Was knowledge of the allocated

interventions adequately prevented?

Were patients blinded?

Were healthcare providers blinded?

Were data collectors blinded?

Were outcome assessors blinded?

Were data analysts blinded?

Definitely yes

Probably yes

Probably no

Definitely no

Was loss to follow-up (missing outcome data) infrequent?

Definitely yes

Probably yes

Probably no

Definitely no

Are reports of the study free of selective outcome reporting?

Definitely yes

Probably yes

Probably no

Definitely no

Was the study apparently free of other problems that could put it at a risk of bias?

Definitely yes

Probably yes

Probably no

Definitely no

Overall risk of bias

If applicable/necessary, per outcome measure

LOW

Some concerns

HIGH

Jokinen, 2023

Definitely yes,

Reason: Randomisation was done beforehand by an independent statistician using a random number generator.

Definitely yes

Reason: treatment protocol was put in a closed envelope

Definitely no

Reason: single-blinded trial. The anaesthesiologist treating the patient followed the protocol assigned to the patient in the envelope and was therefore not blinded.

All analyses on outcomes were blinded.

Definitely yes

Reason: Loss to follow-up was infrequent and similar in intervention and control group.

Probably yes, except for estimated blood loss, there definitely No.

Reason: Mean blood loss not reported in result section, only in discussion. 

Probably yes

Reason: Optimal sample size not met, and blood loss before entering theatre was greater in the control group and although not significantly different, it might have affected the total blood loss.

High concerns: outcome estimated blood loss

Some concerns: all other outcomes

Lumbreras-Marquez (2022)

Definitely yes,

Reason: The randomization schedule

was created using a computer-generated scheme, without stratification.

Definitely yes,

Reason: intervention

and control designations placed by a blinded observer in opaque,

sequentially numbered envelopes

Probably no,

Reason: No information provided on further blinding of the study and data analysis.

Definitely no,

Reason: Study was terminated early

Definitely yes,

Reason: all relevant outcomes were reported.

Optimal sample size not met, thus underpowered due to early termination of study.

Performance bias is a concern if the management changed over te course of the study period. In addition, the statistical significance in the comparison of baseline characteristics is based on a critical standardized difference based on a different sample size.

Some concern: all outcomes

Author, year

Selection of participants

Was selection of exposed and non-exposed cohorts drawn from the same population?

Exposure

Can we be confident in the assessment of exposure?

Outcome of interest

Can we be confident that the outcome of interest was not present at start of study?

Confounding-assessment

Can we be confident in the assessment of confounding factors? 

Confounding-analysis

Did the study match exposed and unexposed for all variables that are associated with the outcome of interest or did the statistical analysis adjust for these confounding variables?

Assessment of outcome

Can we be confident in the assessment of outcome?

Follow up

Was the follow up of cohorts adequate? In particular, was outcome data complete or imputed?

Co-interventions

Were co-interventions similar between groups?

Overall Risk of bias

Definitely yes, probably yes, probably no, definitely no

Definitely yes, probably yes, probably no, definitely no

Definitely yes, probably yes, probably no, definitely no

Definitely yes, probably yes, probably no, definitely no

Definitely yes, probably yes, probably no, definitely no

Definitely yes, probably yes, probably no, definitely no

Definitely yes, probably yes, probably no, definitely no

Definitely yes, probably yes, probably no, definitely no

Low, Some concerns, High

McNamara, 2019

Definitely no,

Different population because different time frame.  Before and after introduction ROTEM guided algorithm (1 July 2012).

Performance bias is a concern if the management changed over te course of the study period

Definitely yes

Reason: Secure record because of protocol and hospital admission

Definitely yes 

Reason: outcome of interest was related to the proceding PPH management.

Probably no

Reason:

No other variables that might confound the data were collected

Probably yes

Reason: Case-control design. However, baseline variables were not provided, and not taken into account as no multivariate analysis were performed.

Probably yes

Reason:

Measured in hospital setting but no information on how it is measured. 

Definitely yes

Reason:

Follow-up full labor/surgery.

No co-interventions present

Some concerns for all outcomes

Snegovskikh, 2018

Definitely no,

Reason: cases and controls not drawn from the same population.

Performance bias is a concern if the management changed over te course of the study period

Definitely yes,

Reason: secure record because of protocol and hospital admission.

Definitely yes 

Reason: outcome of interest was related to the proceding PPH management.

Definitely yes,

Reason: relevant baseline characteriscs and other variables are measured

Probably yes

Reason: Case-control design. However, baseline variables were not taken into account as no multivariate analysis were performed.

Definitely yes

Reason:

Clear information provided in article.  

Definitely yes

Reason:

Follow-up full labor/surgery.

No co-interventions present

Some concerns for all outcomes

References

Reason for exclusion

Aawar N, Alikhan R, Bruynseels D, Cannings-John R, Collis R, Dick J, Elton C, Fernando R, Hall J, Hood K, Lack N, Mallaiah S, Maybury H, Nuttall J, Paranjothy S, Rayment R, Rees A, Sanders J, Townson J, Weeks A, Collins P. Fibrinogen concentrate versus placebo for treatment of postpartum haemorrhage: study protocol for a randomised controlled trial. Trials. 2015 Apr 17;16:169. doi: 10.1186/s13063-015-0670-9. PMID: 25906770; PMCID: PMC4408576.

Design: study protocol

Affronti G, Agostini V, Brizzi A, Bucci L, De Blasio E, Frigo MG, Giorgini C, Messina M, Ragusa A, Sirimarco F, Svelato A. The daily-practiced post-partum hemorrhage management: an Italian multidisciplinary attended protocol. Clin Ter. 2017 Sep-Oct;168(5):e307-e316. doi: 10.7417/T.2017.2026. PMID: 29044353.

Management article

Agarwal S, Laycock HC. The debate ROTEMs on - the utility of point-of-care testing and fibrinogen concentrate in postpartum haemorrhage. Anaesthesia. 2020 Sep;75(9):1247-1251. doi: 10.1111/anae.15193. Epub 2020 Jul 14. PMID: 32662889.

Design: narrative review

Amgalan A, Allen T, Othman M, Ahmadzia HK. Systematic review of viscoelastic testing (TEG/ROTEM) in obstetrics and recommendations from the women's SSC of the ISTH. J Thromb Haemost. 2020 Aug;18(8):1813-1838. doi: 10.1111/jth.14882. PMID: 32356929.

Design: narrative review.

Viscoelastometric Point-of-Care Testing for Vascular Surgery and Obstetrics: A Review of Clinical Utility and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2016 Jan 4. PMID: 26889535.

Wrong design

Antony KM, Mansouri R, Arndt M, Rocky Hui SK, Jariwala P, Mcmullen VM, Teruya J, Aagaard K. Establishing thromboelastography with platelet-function analyzer reference ranges and other measures in healthy term pregnant women. Am J Perinatol. 2015 May;32(6):545-54. doi: 10.1055/s-0034-1396700. Epub 2015 Jan 16. PMID: 25594216.

Wrong outcome measures

Arnolds DE, Scavone BM. Thromboelastographic Assessment of Fibrinolytic Activity in Postpartum Hemorrhage: A Retrospective Single-Center Observational Study. Anesth Analg. 2020 Nov;131(5):1373-1379. doi: 10.1213/ANE.0000000000004796. PMID: 33079858.

Wrong outcome measures

Bareille M, Lecompte T, Mullier F, Roullet S. Are Viscoelastometric Assays of Old Generation Ready for Disposal? Comment on Volod et al. Viscoelastic Hemostatic Assays: A Primer on Legacy and New Generation Devices. J. Clin. Med. 2022, 11, 860. J Clin Med. 2023 Jan 6;12(2):477. doi: 10.3390/jcm12020477. PMID: 36675406; PMCID: PMC9866463.

Wrong outcome measures

Barinov SV, Zhukovsky YG, Dolgikh VT, Medyannikova IV. Novel combined strategy of obstetric haemorrhage management during caesarean section using intrauterine balloon tamponade. J Matern Fetal Neonatal Med. 2017 Jan;30(1):29-33. doi: 10.3109/14767058.2015.1126242. Epub 2016 Jun 1. PMID: 26625194.

Wrong I

Belete M, Gerrans E, Keskar M. Blood management in post-partum haemorrhage, including point of care coagulation tests. Signa Vitae. 2021 May 1;17(3).

Design: narrative review

Bell SF, Collis RE, Bailey C, James K, John M, Kelly K, Kitchen T, Scarr C, Macgillivray E, Collins PW. The incidence, aetiology, and coagulation management of massive postpartum haemorrhage: a two-year national prospective cohort study. Int J Obstet Anesth. 2021 Aug;47:102983. doi: 10.1016/j.ijoa.2021.102983. Epub 2021 Mar 26. Erratum in: Int J Obstet Anesth. 2022 Aug;51:103549. doi: 10.1016/j.ijoa.2022.103549. PMID: 33994274.

No comparative study

Bell SF, Roberts TCD, Freyer Martins Pereira J, De Lloyd L, Amir Z, James D, Jenkins PV, Collis RE, Collins PW. The sensitivity and specificity of rotational thromboelastometry (ROTEM) to detect coagulopathy during moderate and severe postpartum haemorrhage: a prospective observational study. Int J Obstet Anesth. 2022 Feb;49:103238. doi: 10.1016/j.ijoa.2021.103238. Epub 2021 Nov 8. PMID: 34840018.

Wrong outcome measures

Bell SF, de Lloyd L, Preston N, Collins PW. Managing the coagulopathy of postpartum hemorrhage: an evolving role for viscoelastic hemostatic assays. J Thromb Haemost. 2023 Aug;21(8):2064-2077. doi: 10.1016/j.jtha.2023.03.029. Epub 2023 Apr 3. PMID: 37019365.

Design: case report

Belotserkovtseva, L. D. and Zinin, V. N. and Kovalenko, L. V. and Pankratov, V. V. Assessment of the effectiveness of “Patient Blood Management” approach in a level III maternity unit. Voprosy Ginekologii, Akusherstva i Perinatologii. 2022; 21(2), 75-82; doi:10.20953/1726-1678-2022-3-75-82

Language: Russian

Bunch CM, Berquist M, Ansari A, McCoy ML, Langford JH, Brenner TJ, Aboukhaled M, Thomas SJ, Peck E, Patel S, Cancel E, Al-Fadhl MD, Zackariya N, Thomas AV, Aversa JG, Greene RB, Seder CW, Speybroeck J, Miller JB, Kwaan HC, Walsh MM. The Choice between Plasma-Based Common Coagulation Tests and Cell-Based Viscoelastic Tests in Monitoring Hemostatic Competence: Not an either-or Proposition. Semin Thromb Hemost. 2022 Oct;48(7):769-784. doi: 10.1055/s-0042-1756302. Epub 2022 Sep 29. PMID: 36174601.

Design: narrative review

Butwick A, Lyell D, Goodnough L. How do I manage severe postpartum hemorrhage? Transfusion. 2020 May;60(5):897-907. doi: 10.1111/trf.15794. Epub 2020 Apr 22. PMID: 32319687.

Management article

Butwick A, Ting V, Ralls LA, Harter S, Riley E. The association between thromboelastographic parameters and total estimated blood loss in patients undergoing elective cesarean delivery. Anesth Analg. 2011 May;112(5):1041-7. doi: 10.1213/ANE.0b013e318210fc64. Epub 2011 Apr 7. PMID: 21474664.

No comparative study

Butwick AJ, Goodnough LT. Transfusion and coagulation management in major obstetric hemorrhage. Curr Opin Anaesthesiol. 2015 Jun;28(3):275-84. doi: 10.1097/ACO.0000000000000180. PMID: 25812005; PMCID: PMC4567035.

Design: narrative review

Chavan R, Latoo MY. Recent advances in the management of major obstetric haemorrhage. British Journal of Medical Practitioners. 2013 Mar 1;6(1).

Design: narrative review

Cheng SM, Lew E. Obstetric haemorrhage–Can we do better?. Trends in Anaesthesia and Critical Care. 2014 Aug 1;4(4):119-26.

Design: narrative review/management article

Collins P. Point-of-care coagulation testing for postpartum haemorrhage. Best Pract Res Clin Anaesthesiol. 2022 Dec;36(3-4):383-398. doi: 10.1016/j.bpa.2022.08.002. Epub 2022 Aug 20. PMID: 36513433.

Management article/narrative review

Collins P, Abdul-Kadir R, Thachil J; Subcommittees on Women' s Health Issues in Thrombosis and Haemostasis and on Disseminated Intravascular Coagulation. Management of coagulopathy associated with postpartum hemorrhage: guidance from the SSC of the ISTH. J Thromb Haemost. 2016 Jan;14(1):205-10. doi: 10.1111/jth.13174. Epub 2015 Dec 23. PMID: 27028301.

Design: narrative review/management article

Collins PW, Bell SF, de Lloyd L, Collis RE. Management of postpartum haemorrhage: from research into practice, a narrative review of the literature and the Cardiff experience. Int J Obstet Anesth. 2019 Feb;37:106-117. doi: 10.1016/j.ijoa.2018.08.008. Epub 2018 Aug 25. PMID: 30322667.

Design: narrative review

Collins, P. W. and Cannings-John, R. and Bruynseels, D. and Mallaiah, S. and Dick, J. and Elton, C. and Weeks, A. and Sanders, J. and Aawar, N. and Townson, J. and Hood, K. Collins PW, Cannings-John R, Bruynseels D, Mallaiah S, Dick J, Elton C, Weeks A, Sanders J, Aawar N, Townson J, Hood K, Hall J, Harding K, Gauntlett R, Collis R; OBS2 study collaborators. Viscoelastometry guided fresh frozen plasma infusion for postpartum haemorrhage: OBS2, an observational study. Br J Anaesth. 2017 Sep 1;119(3):422-434. doi: 10.1093/bja/aex245. PMID: 28969328.

No comparative study

Collins PW, Cannings-John R, Bruynseels D, Mallaiah S, Dick J, Elton C, Weeks AD, Sanders J, Aawar N, Townson J, Hood K, Hall JE, Collis RE. Viscoelastometric-guided early fibrinogen concentrate replacement during postpartum haemorrhage: OBS2, a double-blind randomized controlled trial. Br J Anaesth. 2017 Sep 1;119(3):411-421. doi: 10.1093/bja/aex181. PMID: 28969312.

Wrong comparison: fibrinogen concentrate vs. Placebo

Collis R, Bell S. The Role of Thromboelastography during the Management of Postpartum Hemorrhage: Background, Evidence, and Practical Application. Semin Thromb Hemost. 2023 Mar;49(2):145-161. doi: 10.1055/s-0042-1757895. Epub 2022 Nov 1. PMID: 36318958.

Design: narrative review

Collis R, Guasch E. Managing major obstetric haemorrhage: Pharmacotherapy and transfusion. Best Pract Res Clin Anaesthesiol. 2017 Mar;31(1):107-124. doi: 10.1016/j.bpa.2017.02.001. Epub 2017 Feb 9. PMID: 28625299.

Design: narrative review

Collis RE, Kenyon C, Roberts TCD, McNamara H. When does obstetric coagulopathy occur and how do I manage it? Int J Obstet Anesth. 2021 May;46:102983. doi: 10.1016/j.ijoa.2021.102983. PMID: 33775682.

Design: narrative review

David JS, Imhoff E, Parat S, Augey L, Geay-Baillat MO, Incagnoli P, Tazarourte K. Use of thrombelastography to guide posttraumatic hemostatic therapy: More coagulation factor concentrates and less allogenic blood transfusion? Anaesth Crit Care Pain Med. 2015 Dec;34(6):339-43. doi: 10.1016/j.accpm.2015.06.004. PMID: 26507909.

Language: French

De Lange NM, Van Rheenen-Flach LE, Lance MD, Mooyman L, Woiski M, Van Pampus EC, Porath M, Bolte AC, Smits L, Henskens YM, Scheepers HC. Peri-partum reference ranges for ROTEM thromboelastometry. Br J Anaesth. 2014 Jun;112(6):1093-101. doi: 10.1093/bja/aet557. PMID: 24554543.

Wrong outcome measures

Dias JD, Butwick AJ, Hartmann J, Waters JH. Viscoelastic haemostatic point-of-care assays in the management of postpartum haemorrhage: a narrative review. Anaesthesia. 2021 Aug;76 Suppl 4:120-131. doi: 10.1111/anae.15454. PMID: 33525056.

Design: narrative review

Drumheller BC, Stein DM, Moore LJ, Rizoli SB, Cohen MJ. Thromboelastography and rotational thromboelastometry for the surgical intensivist: A narrative review. J Trauma Acute Care Surg. 2019 Apr;86(4):710-721. doi: 10.1097/TA.0000000000002185. PMID: 30629007.

Design: narrative review

Ekelund K, Hanke G, Stensballe J, Wikkelsøe A, Albrechtsen CK, Afshari A. Hemostatic resuscitation in postpartum hemorrhage - A supplement to surgery. Acta Obstet Gynecol Scand. 2015 Jun;94(6):680-92. doi: 10.1111/aogs.12607. PMID: 25644927.

Design: narrative review

Eremeeva DR, Zainulina MS. Application of the rotational thromboelastography/thromboelastometry for assessment of massive obstetric blood loss in a high risk group. J Matern Fetal Neonatal Med. 2017 Jan;30(1):34-38. doi: 10.3109/14767058.2015.1126243. PMID: 26626538.

Language: Russian

Fan G, Yuan M, Niu H, Lu Y, Yang H, Liang X. The Significance of Thromboelastogram in Predicting Postpartum Hemorrhage and Guiding Blood Transfusion. Clin Lab. 2021 Dec 1;67(12). doi: 10.7754/Clin.Lab.2021.210317. PMID: 34915670.

This article has been retracted

Fan G, Yuan M, Niu H, Lu Y, Yang H, Liang X. Retraction of: The Significance of Thromboelastogram in Predicting Postpartum Hemorrhage and Guiding Blood Transfusion. Clin Lab. 2023 Feb 1;69(2). doi: 10.7754/Clin.Lab.2021.210399. PMID: 37470307.

Retracted paper

Fiol AG, Yoo J, Yanez D, Fardelmann KL, Salimi N, Alian M, Mancini P, Alian A. Baseline rotational thromboelastometry (ROTEM) values in a healthy, diverse obstetric population and parameter changes by pregnancy-induced comorbidities. Int J Obstet Anesth. 2022 Aug;51:103549. doi: 10.1016/j.ijoa.2022.103549. PMID: 35752594.

Wrong population: women undergoing vaginal or cesarean delivery with a history of or at risk for PPH. Exclusion criterium = active bleeding

Fudaba M, Tachibana D, Misugi T, Nakano A, Koyama M. Excessive fibrinolysis detected with thromboelastography in a case of amniotic fluid embolism: fibrinolysis may precede coagulopathy. J Obstet Gynaecol Res. 2021 Mar;47(3):1229-1233. doi: 10.1111/jog.14648. PMID: 33368864.

Design: case report

Görlinger K, Dirkmann D, Solomon C, Hanke AA. Fast interpretation of thromboelastometry in non-cardiac surgery: Reliability in patients with hypo-, normo-, and hypercoagulability. Br J Anaesth. 2017 May 1;118(5):755-764. doi: 10.1093/bja/aex058. PMID: 28403406.

Wrong population: patients undergoing non-cardiac surgery

Görlinger K, Pérez-Ferrer A, Dirkmann D, Saner F, Maegele M, Calatayud ÁAP, Kim TY. The role of evidence-based algorithms for rotational thromboelastometry-guided bleeding management. Korean J Anesthesiol. 2019 Dec;72(6):297-322. doi: 10.4097/kja.19169. PMID: 30929423.

Design: narrative review

Gehrie EA, Baine I, Booth GS. Pathology consultation on viscoelastic studies of coagulopathic obstetrical patients. Am J Clin Pathol. 2019 Jan 1;151(1):1-7. doi: 10.1093/ajcp/aqy101. PMID: 30285068.

Design: narrative review

Getrajdman C, Sison M, Lin HM, Katz D. The effects of hemodilution on coagulation in term parturients: an in vitro study utilizing rotational thromboelastometry. Int J Obstet Anesth. 2021 May;46:102983. doi: 10.1016/j.ijoa.2021.102983. PMID: 33775682.

No comparative study

Gillissen A, van den Akker T, Caram-Deelder C, Henriquez DDCA, Bloemenkamp KWM, Eikenboom J, van der Bom JG, de Maat MPM. Comparison of thromboelastometry by ROTEM Delta and ROTEM Sigma in women with postpartum haemorrhage. Int J Lab Hematol. 2021 Aug;43 Suppl 1:142-150. doi: 10.1111/ijlh.13445. PMID: 33522624.

Wrong outcome measures

Giouleka S, Tsakiridis I, Kalogiannidis I, Mamopoulos A, Tentas I, Athanasiadis A, Dagklis T. Postpartum Hemorrhage: A Comprehensive Review of Guidelines. Obstet Gynecol Surv. 2021 Oct;76(10):613-623. doi: 10.1097/OGX.0000000000000931. PMID: 34706105.

A review of guidelines

Gonzalez-Fiol A, Fardelmann KL, Yanez D, Salimi N, Mancini P, Alian A. Comparison between the Rotational Thromboelastometry (ROTEM) Delta device against the Cartridge-based Thromboelastography 6s and Quantra in a healthy third trimester pregnant cohort. Int J Obstet Anesth. 2022 Aug;51:103549. doi: 10.1016/j.ijoa.2022.103549. PMID: 35752594.

Wrong outcome measures

Graves S, Montemorano L, Rood K, Costantine MM, Fiorini K, Cackovic M. Viscoelastic Testing in An Obstetric Population at High-Risk of Hemorrhage. Am J Perinatol. 2022 Jan;39(2):154-160. doi: 10.1055/s-0040-1714397. PMID: 32791584.

No comparative study

Grottke O, Mallaiah S, Karkouti K, Saner F, Haas T. Fibrinogen Supplementation and Its Indications. Crit Care. 2020 Mar 24;24(1):110. doi: 10.1186/s13054-020-2799-5. PMID: 32204757.

Design: narrative review

Gultekin-Elbir EE, Pelletier JPR, Sylvester-Armstrong KR, Genc MR. Is thromboelastography reliable in postpartum coagulopathies? Two case reports and a literature review. J Clin Anesth. 2021 Dec;75:110489. doi: 10.1016/j.jclinane.2021.110489. PMID: 34537559.

Design: case report

Haas T, Görlinger K, Grassetto A, Agostini V, Simioni P, Nardi G, Ranucci M. Thromboelastometry for guiding bleeding management of the critically ill patient: a systematic review of the literature. Minerva Anestesiol. 2018 Sep;84(9):1090-1106. doi: 10.23736/S0375-9393.18.12484-2. PMID: 29667691.

Design: narrative review

Hartmann J, Hermelin D, Levy JH. Viscoelastic testing: an illustrated review of technology and clinical applications. Res Pract Thromb Haemost. 2022 Aug 25;6(6):e12793. doi: 10.1002/rth2.12793. PMID: 36051576.

Design: illustrated review

Hill JS, Devenie G, Powell M. Point-of-care testing of coagulation and fibrinolytic status during postpartum haemorrhage: Developing a thrombelastography-guided transfusion algorithm. Anaesth Intensive Care. 2011 Nov;39(6):1054-60. PMID: 22165358.

No comparative study (reference values)

Huissoud C, Carrabin N, Audibert F, Levrat A, Massignon D, Berland M, Rudigoz RC. Bedside assessment of fibrinogen level in postpartum haemorrhage by thrombelastometry. BJOG. 2009 Jul;116(8):1097-102. doi: 10.1111/j.1471-0528.2009.02187.x. PMID: 19438496.

Wrong comparison: women with PPH vs women withoug PPH

Hunt BJ, Allard S, Keeling D, Norfolk D, Stanworth SJ, Pendry K. A practical guideline for the haematological management of major haemorrhage. Br J Haematol. 2015 Jul;170(6):788-803. doi: 10.1111/bjh.13580. PMID: 26018837.

Management article

Jambor C, Kozek-Langenecker SA, Frietsch T, Knels R. Thrombelastography Should Be Included in the Algorithm for the Management of Postpartum Hemorrhage. Anesth Analg. 2010 Mar 1;110(3):1001. doi: 10.1213/ANE.0b013e3181c8b8e4. PMID: 20185674.

Design: letter to the editor

Karlsson O. Experience of Point-of-Care Devices in Obstetrical Care. Semin Thromb Hemost. 2017 Oct;43(7):683-689. doi: 10.1055/s-0037-1602657. PMID: 28750470.

Design: experience article

Karlsson O, Jeppsson A, Hellgren M. Major obstetric haemorrhage: Monitoring with thromboelastography, laboratory analyses or both? Int J Obstet Anesth. 2014 Feb;23(1):10-7. doi: 10.1016/j.ijoa.2013.07.003. PMID: 24321520.

Wrong comparison: women with PPH vs women without PPH

Karlsson O, Sporrong T, Hillarp A, Jeppsson A, Hellgren M. Prospective longitudinal study of thromboelastography and standard hemostatic laboratory tests in healthy women during normal pregnancy. Anesth Analg. 2012 Oct;115(4):890-8. doi: 10.1213/ANE.0b013e3182652a16. PMID: 22798531.

No comparison

Kaufner L, Henkelmann A, Von Heymann C, Feldheiser A, Mickley L, Niepraschk-Von Dollen K, Grittner U, Henrich W, Bamberg C. Can prepartum thromboelastometry-derived parameters and fibrinogen levels really predict postpartum hemorrhage? J Perinat Med. 2018 Feb 23;46(2):179-187. doi: 10.1515/jpm-2016-0361. PMID: 28493831.

Comparing women with and without PPH

Khanna P, Sinha C, Singh AK, Kumar A, Sarkar S. The role of point of care thromboelastography (TEG) and thromboelastometry (ROTEM) in management of Primary postpartum haemorrhage: A meta-analysis and systematic review. J Anaesthesiol Clin Pharmacol. 2021 Jul-Sep;37(3):317-328. doi: 10.4103/joacp.JOACP_347_19. PMID: 34759540.

exclude Want niet alle 5 zijn de RCT zijn geinclude.lage kwaliteit

Kroh S, Waters JH. Obstetrical Hemorrhage. Anesthesiol Clin. 2021 Jun;39(2):265-279. doi: 10.1016/j.anclin.2021.02.003. PMID: 34024431.

Management article

Kumaraswami S, Butwick A. Latest advances in postpartum hemorrhage management. Curr Opin Anaesthesiol. 2022 Jun 1;35(3):274-280. doi: 10.1097/ACO.0000000000001131. PMID: 35671052.

Design: narrative review

Levi M, Hunt BJ. A critical appraisal of point-of-care coagulation testing in critically ill patients. J Thromb Haemost. 2015 Nov;13(11):1960-7. doi: 10.1111/jth.13142. PMID: 26382995.

Design: narrative review

Li CQ, Wang DX, Wei XY. Perioperative management of pregnant women combined with congenital fibrinogen deficiency: four cases report and literature review. Chin Med J (Engl). 2015 Jan 20;128(2):275-8. doi: 10.4103/0366-6999.149236. PMID: 25591577.

Language: Chinese

Liew-Spilger AE, Sorg NR, Brenner TJ, Langford JH, Berquist M, Mark NM, Moore SH, Mark J, Baumgartner S, Abernathy MP. Utilization of point-of-care ultrasound and rotational thromboelastometry (ROTEM) in the diagnosis and management of amniotic fluid embolism presenting as post-partum hemorrhage and cardiac arrest. Am J Case Rep. 2022 Mar 10;23:e935469. doi: 10.12659/AJCR.935469. PMID: 35264581.

Design: narrative review

Mallaiah S, Barclay P, Harrod I, Chevannes C, Bhalla A. Introduction of an algorithm for ROTEM-guided fibrinogen concentrate administration in major obstetric haemorrhage. Anaesthesia. 2015 Feb;70(2):166-75. doi: 10.1111/anae.12859. PMID: 25388828.

Wrong intervention and control

Mao YJ, Yang ZJ. The use of thromboelastography for the peripartum management of a patient with platelet storage pool disorder. Int J Obstet Anesth. 2019 Feb;37:127-130. doi: 10.1016/j.ijoa.2018.10.007. PMID: 30420140.

Language: Chinese

Markley JC, Carusi DA. Clinical value of early viscoelastometric point-of-care testing during postpartum hemorrhage for the prediction of severity of bleeding: A multicenter prospective cohort study in the Netherlands. Am J Obstet Gynecol. 2022 Jan;226(1):S1-S11. doi: 10.1016/j.ajog.2021.06.077. PMID: 34998498.

Design: narrative review

Matkovic E, Lindholm PF. Trials and Tribulations of Viscoelastic-Based Determination of Fibrinogen Concentration. Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221121290. doi: 10.1177/10760296221121290. PMID: 36062470.

Design: narrative review

McNamara H, Mallaiah S. Postpartum Hemorrhage: What's New? Hematology Am Soc Hematol Educ Program. 2019 Dec 6;2019(1):539-547. doi: 10.1182/hematology.2019000061. PMID: 31808868.

Management article

McNamara H, Mallaiah S, Barclay P, Chevannes C, Bhalla A. Role of Viscoelastic and Conventional Coagulation Tests for Management of Blood Product Replacement in the Bleeding Patient. Transfus Med Rev. 2019 Oct;33(4):217-223. doi: 10.1016/j.tmrv.2019.09.001. PMID: 31611133.

Design: case report

Merrill J, Sultan P, Sharawi N. Managing coagulopathy following PPH. Best Pract Res Clin Obstet Gynaecol. 2019 Nov;61:106-120. doi: 10.1016/j.bpobgyn.2019.06.001. PMID: 31320209.

Design: narrative review/case report

Nakamura E, Matsunaga S, Kikuchi A, Takai Y. Coagulopathy and placental abruption: Changing management with ROTEM-guided fibrinogen concentrate therapy. J Obstet Gynaecol Res. 2019 Jan;45(1):38-43. doi: 10.1111/jog.13813. PMID: 30255501.

Wrong outcome measures

Nath SS, Pandey CK, Kumar S. Advances in anesthetic and obstetric management of patients with placenta accreta spectrum. Int J Obstet Anesth. 2021 May;46:102983. doi: 10.1016/j.ijoa.2021.102983. PMID: 33775682.

Design: narrative review

Nelson DB, Ogunkua O, Cunningham FG. Comparative retrospective study on the validity of point-of-care testing device for massive obstetrical hemorrhage: dry hematology vs thromboelastography. Am J Obstet Gynecol MFM. 2021 Nov;3(6):100475. doi: 10.1016/j.ajogmf.2021.100475. PMID: 34438047.

Design: narrative review

Ondondo BO. Clinical application of viscoelastic point-of-care tests of coagulation-shifting paradigms. Afr J Lab Med. 2021 Oct 29;10(1):1316. doi: 10.4102/ajlm.v10i1.1316. PMID: 34858792.

wrong comparison

Pérez-Calatayud ÁA, Briones-Garduño JC, Rojas-Arellano ML. Point-of-Care Viscoelastic Tests in the Management of Obstetric Hemorrhage. Rev Bras Ginecol Obstet. 2021 Aug;43(8):630-636. doi: 10.1055/s-0041-1735229. PMID: 34350988.

Language: Spanish

Pacheco LD, Saade GR, Hankins GDV. Medical management of postpartum hemorrhage: An update. Semin Perinatol. 2019 Feb;43(1):22-26. doi: 10.1053/j.semperi.2018.11.005. PMID: 30578145.

Management article

Perelman A, Limaye M, Blakemore J, Hoskins IA. Thromboelastography versus standard coagulation assays in patients with postpartum hemorrhage. J Matern Fetal Neonatal Med. 2017 Jan;30(1):39-43. doi: 10.3109/14767058.2015.1126244. PMID: 26626539.

No comparison

Phillips AN, Kirkland LL, Wagner WE, Melamed R, Tierney DM. Management of major obstetric haemorrhage using ROTEM point-of-care haemostasis analysers can reduce blood product usage without increasing fibrinogen replacement therapy. Blood Transfus. 2016 Nov;14(6):491-497. doi: 10.2450/2016.0303-15. PMID: 27483477.

Design: case report

Rajpal G, Pomerantz JM, Ragni MV, Waters JH, Vallejo MC. Use of thromboelastography and rotational thromboelastometry for the rational and opportune transfusion of hemoderivatives in obstetric hemorrhage. Transfus Apher Sci. 2017 Oct;56(5):728-732. doi: 10.1016/j.transci.2017.08.011. PMID: 28867136.

Design: case report

Ramler PI, Gillissen A, Henriquez DDCA, Caram-Deelder C, Markovski AA, de Maat MPM, Duvekot JJ, Eikenboom JCJ, Bloemenkamp KWM, van Lith JMM, van den Akker T, van der Bom JG. Clinical value of early assessment of hyperfibrinolysis by rotational thromboelastometry during postpartum hemorrhage for the prediction of severity of bleeding: A multicenter prospective cohort study in the Netherlands. J Thromb Haemost. 2022 Jan;20(1):38-48. doi: 10.1111/jth.15538. PMID: 34608767.

No comparison between TEG/ROTEM tests and standard lab tests

Ranucci M, Di Dedda U, Baryshnikova E. Use of earlier-reported rotational thromboelastometry parameters to evaluate clotting status, fibrinogen, and platelet activities in postpartum hemorrhage compared to surgery and intensive care patients. Thromb Res. 2019 May;177:103-111. doi: 10.1016/j.thromres.2019.03.001. PMID: 30870622.

Design: narrative review

Rigouzzo A, Louvet N, Favier R, Ore MV, Piana F, Girault L, Farrugia M, Sabourdin N, Constant I. Effects of rotational thromboelastometry-guided transfusion management in patients undergoing surgical intervention for postpartum hemorrhage: An observational study. Int J Obstet Anesth. 2021 May;46:102983. doi: 10.1016/j.ijoa.2021.102983. PMID: 33775682.

No comparative study

Roberts TCD, De Lloyd L, Bell SF, Cohen L, James D, Ridgway A, Jenkins V, Field V, Collis RE, Collins PW. The role of viscoelastic testing in the management of the parturient. Int J Obstet Anesth. 2022 Aug;51:103549. doi: 10.1016/j.ijoa.2022.103549. PMID: 35752594.

No comparative study

Roullet S, de Maistre E, Ickx B, Blais N, Susen S, Faraoni D, Garrigue D, Bonhomme F, Godier A, Lasne D. Position of the French Working Group on Perioperative Haemostasis (GIHP) on viscoelastic tests: What role for which indication in bleeding situations? Anaesth Crit Care Pain Med. 2020 Oct;39(5):631-635. doi: 10.1016/j.accpm.2020.07.009. PMID: 32745697.

Design: narrative review

Roullet S, de Maistre E, Ickx B, Blais N, Susen S, Faraoni D, Garrigue D, Bonhomme F, Godier A, Lasne D, Albaladejo P, Belisle S, Blais N, Bonhomme F, Borel-Derlon A, Borg JY, Bosson JL, Cohen A, Collet JP, de Maistre E, Faraoni D, Fontana P, Garrigue Huet D, Godier A, Gruel Y, Guay J, Hardy JF, Huet Y, Ickx B, Laporte S, Lasne D, Levy JH, Llau J, Le Gal G, Lecompte T, Lessire S, Longrois D, Madi-Jebara S, Marret E, Mas JL, Mazighi M, Mismetti P, Morange PE, Motte S, Mullier F, Nathan N, Nguyen P, Ozier Y, Pernod G, Rosencher N, Roullet S, Roy PM, Samama CM, Schlumberger S, Schved JF, Sié P, Steib A, Susen S, van Belle E, Van der Linden P, Vincentelli A, Zufferey P. Position of the French Working Group on Perioperative Haemostasis (GIHP) on viscoelastic tests: What role for which indication in bleeding situations? Anaesth Crit Care Pain Med. 2020 Oct;39(5):631-635. doi: 10.1016/j.accpm.2020.07.009. PMID: 32745697.

Design: narrative review

Schöchl H, Solomon C, Voelckel W. Thromboelastometry in the perioperative setting. Anaesthesia. 2012 Jan;67 Suppl 1:72-7. doi: 10.1111/j.1365-2044.2011.06960.x. PMID: 22167408.

No comparative study

Schol PBB, Lange ND, Henskens Y, Smits LJM, Smeets NAC, Scheepers HCJ. Restrictive versus liberal fluid administration strategy (REFILL study) in postpartum hemorrhage and its effects on thromboelastometry (ROTEM) values: a randomized, controlled trial. BMC Pregnancy Childbirth. 2021 Jun 5;21(1):416. doi: 10.1186/s12884-021-03886-3. PMID: 34090378.

Wrong I, C and P

Sharp G, Young CJ. Point-of-care viscoelastic assay devices (rotational thromboelastometry and thromboelastography): a primer for surgeons. ANZ J Surg. 2021 May;91(5):841-846. doi: 10.1111/ans.16788. PMID: 34031989.

Wrong P: surgically bleeding patients

Shin HJ, Nam SW, Koo BW, Kim J, Hwang JW, Do SH, Na HS. Rotational thromboelastometry during Cesarean section as a predictive evaluation for the progression of persistent postpartum hemorrhage in parturients with placenta previa: A prospective observational study. J Clin Med. 2021 Dec 14;10(24):5869. doi: 10.3390/jcm10245869. PMID: 34945164.

Wrong comparison: PPH vs. No-PPH. Wrong population (?)

Shreeve NE, Barry JA, Deutsch LR, Gomez K, Kadir RA. Changes of Coagulation and Fibrinolytic Status Detected by Thromboelastography (TEG6s R) in Pregnancy, Labor, Early Postpartum, Postpartum Hemorrhage and Heparin Treatment for Perinatal Venous Thrombosis. J Clin Med. 2022 Jan 28;11(3):693. doi: 10.3390/jcm11030693. PMID: 35160157.

Wrong comparison, wrong outcome measures

Snegovskikh D, Walton Z, Souzdalnitski D. Functional fibrinogen (FLEV-TEG) versus the Clauss method in an obstetric population: A comparative study. Int J Obstet Anesth. 2019 Feb;37:127-130. doi: 10.1016/j.ijoa.2018.10.007. PMID: 30420140.

Design: narrative review

Solomon C, Collis RE, Collins PW. Haemostatic monitoring during postpartum haemorrhage and implications for management. Br J Anaesth. 2015 Dec;115 Suppl 2:ii85-ii92. doi: 10.1093/bja/aev372. PMID: 26658206.

Design: narrative review

Spahn DR, Spahn GH, Stein P. Indications and Risks of Fibrinogen in Surgery and Trauma. Semin Thromb Hemost. 2016 Mar;42(2):147-54. doi: 10.1055/s-0035-1564835. PMID: 26838697.

Wrong population, wrong design (narrative)

Spasiano A, Matellon C, Orso D, Brussa A, Cafagna M, Marangone A, Dogareschi T, Bove T, Giacomello R, Fontana D, Vetrugno L, Della Rocca G. Changes in thromboelastography parameters in pregnancy, labor, and the immediate postpartum period. Int J Lab Hematol. 2021 Aug;43(4):772-780. doi: 10.1111/ijlh.13445. PMID: 33522624.

Wrong outcome measures

Suemitsu C, Fudaba M, Kitada K, Kurihara Y, Tahara M, Hamuro A, Misugi T, Nakano A, Koyama M, Tachibana D. Significance of thromboelastography in the monitoring of maternal coagulation disorders in preeclampsia. J Obstet Gynaecol Res. 2022 Jan;48(1):59-65. doi: 10.1111/jog.15062. PMID: 34672098.

Wrong outcome measures

Tahitu M, Ramler PI, Gillissen A, Caram-Deelder C, Henriquez DDCA, de Maat MPM, Duvekot JJ, Eikenboom J, Bloemenkamp KWM, van den Akker T, van der Bom JG. Assessment of Coagulation by Thromboelastography During Ongoing Postpartum Hemorrhage: A Retrospective Cohort Analysis. J Clin Med. 2022 Feb 15;11(4):1001. doi: 10.3390/jcm11041001. PMID: 35207289.

No comparative study

Toffaletti JG, Buckner KA. Point-of-Care Thromboelastometry in the Management of Acute Obstetric Hemorrhage. J Appl Lab Med. 2019 Jan;3(4):684-695. doi: 10.1373/jalm.2018.026476. PMID: 31639736.

Wrong population, wrong outcome

Tsang Y, Kurniawan AR, Tomasek O, Hessian E, Bramley D, Daly O, Simons K, Imberger G. Evaluating the Association Between Fibrinogen and Rotational Thromboelastometry and the Progression to Severe Obstetric Hemorrhage. Anesth Analg. 2022 May 1;134(5):1001-1010. doi: 10.1213/ANE.0000000000005909. PMID: 35180166.

Wrong intervention

Waters JH. Thromboelastography predicts risks of obstetric complication occurrence in (hypo)dysfibrinogenemia patients under non-pregnant state. Thromb Res. 2015 Oct;136(4):783-5. doi: 10.1016/j.thromres.2015.08.010. PMID: 26319301.

Management article/narrative review

Whiting P, Al M, Westwood M, Ramos IC, Ryder S, Armstrong N, Misso K, Ross J, Severens J, Kleijnen J. Viscoelastic point-of-care testing to assist with the diagnosis, management and monitoring of haemostasis: A systematic review and cost-effectiveness analysis. Health Technol Assess. 2015 Jul;19(58):1-228. doi:10.3310/hta19580. PMID: 26215747; PMCID: PMC4781169.

Only 2 prediction studies on PPH included. Those studies do not match our PICO

Yurashevich M, Rosser M, Small M, Grotegut C, Kota N, Toffaletti J, Allen T. Evaluating the Association Between Fibrinogen and Rotational Thromboelastometry and the Progression to Severe Obstetric Hemorrhage. Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231175089. doi: 10.1177/10760296231175089. PMID: 37186763; PMCID: PMC10192949.

No comparative study

Zhou J, Xin Y, Ding Q, Jiang L, Chen Y, Dai J, Lu Y, Wu X, Liang Q, Wang H, Wang X. Thromboelastography predicts risks of obstetric complication occurrence in (hypo)dysfibrinogenemia patients under non-pregnant state. Clin Exp Pharmacol Physiol. 2016 Feb;43(2):149-56. doi: 10.1111/1440-1681.12509. PMID: 26510121.

Wrong P

Zhu X, Tang J, Huang X, Zhou Y. Diagnostic value of fibrinogen combined with thromboelastogram in postpartum hemorrhage after vaginal delivery. Am J Transl Res. 2022 Mar 15;14(3):1877-1883. PMID: 35422901; PMCID: PMC8991141.

Wrong comparison: women with PPH vs women without PPH

Mallaiah S, Barclay P, Harrod I, Chevannes C, Bhalla A. Introduction of an algorithm for ROTEM-guided fibrinogen concentrate administration in major obstetric haemorrhage. Anaesthesia. 2015 Feb;70(2):166-75. doi: 10.1111/anae.12859. Epub 2014 Oct 7. Erratum in: Anaesthesia. 2015 Nov;70(11):1334. doi: 10.1111/anae.13271. PMID: 25289791.

Correction

Fan G, Yuan M, Niu H, Lu Y, Yang H, Liang X. The Significance of Thromboelastogram in Predicting Postpartum Hemorrhage and Guiding Blood Transfusion. Clin Lab. 2022 Feb 1;68(2). doi: 10.7754/Clin.Lab.2021.210317. Retraction in: Clin Lab. 2023 Feb 1;69(2). doi: 10.7754/Clin.Lab.2021.210399. PMID: 35142183.

Retracted paper