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Viscoelastic Testing: A Potential lifesaver in Postpartum Hemorrhage
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Viscoelastic testing shows promise in reducing postpartum hemorrhage deaths | Image Credit: © kittyfly – © kittyfly – stock.adobe.com.
In a recent review published in the International Journal of Obstetric Anesthesia, viscoelastic testing (VET) was indicated as a potential driver of reducing postpartum hemorrhage mortalities.1
the blood-monitoring technology is minimally invasive and can identify the progress of blood clotting, alongside informing clinicians about the most effective type of blood transfusion for stopping hemorrhage. Alongside reducing the risk of mortality,VET has been highlighted as a method to save costs over time and reduce health disparities.1
“Maternal mortality is a serious public health challenge, including in the US, which is especially troubling because the majority of cases are preventable,” said Susanne Hempel, PhD, professor at the Keck School of Medicine. “the problem is that severe postpartum hemorrhage is a rare event,so hospitals are not always prepared for it.”1
Limited Research but Promising Potential
The review highlighted a gap in research, but the available evidence suggests VET can considerably improve outcomes. Currently, managing postpartum hemorrhage often relies on standardized transfusion protocols, which may not always be optimal for individual patients. VET offers a personalized approach, allowing clinicians to tailor treatment based on a patient’s specific coagulation profile.
How Viscoelastic Testing Works
VET analyzes the viscoelastic properties of whole blood, assessing how it clots, strengthens, and breaks down. This provides real-time information on:
- Clotting Time: How long it takes for a clot to form.
- Clot Strength: The firmness of the clot.
- Clot Stability: how well the clot holds together over time.
this information helps clinicians determine if a patient needs blood products, and if so, which ones – red blood cells, platelets, or clotting factors – will be most effective.
Benefits of implementing VET
Implementing VET in postpartum hemorrhage management offers several potential benefits:
- Reduced Mortality: More targeted treatment can lead to faster control of bleeding and reduced risk of death.
- Cost Savings: Avoiding unneeded transfusions can lower healthcare costs.
- reduced Health Disparities: Ensuring appropriate treatment for all patients, regardless of socioeconomic status or access to care.
- Improved Patient Outcomes: Personalized treatment leads to better overall recovery.
Challenges to Wider Adoption
Despite its promise, wider adoption of VET faces some challenges. These include:
- Cost of Equipment: VET machines can be expensive, posing a barrier for some hospitals.
- Training Requirements: Clinicians need specialized training to interpret VET results accurately.
- Lack of Standardized protocols: Clear guidelines for VET use in postpartum hemorrhage management are still evolving.
Future Directions
Further research is needed to establish standardized protocols and demonstrate the long-term benefits of VET. Studies should focus on: