Point-of-care testing has found application across the breadth of healthcare, a recent prime example being the role of viscoelastic POC testing in post-partum bleeding management in obstetrics.
The value of point-of- care (POC) coagulation testing using viscoelastic technology to address obstetric bleeding is leading to a new approach in mamaging with post-partum haemorrhage (PPH), which is still the main cause of maternal death.1
It is recognised that PPH can be exacerbated by coagulopathy, with a decline in fibrinogen levels known to be the first indicator of the condition. However, the clinical utility of laboratory fibrinogen testing to predict progression of PPH has always been limited because ‘time to results’ can be 60–90 minutes. Faced with PPH, this can be too long to wait. The bleed will either have stopped or results are retrospective, with the clinician having relied on empirical transfusion ratios.
The ability to monitor fibrinogen and other parameters at the point of care within 10–15 minutes would enable surgeons to deliver early, targeted fibrinogen replacement that might stem the progression of PPH. It is equally important to be able to monitor and interpret other coagulation parameters at the same time, as research shows that replacing fibrinogen will not improve outcomes if levels are normal.2
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