Postpartum Haemorrhage Clinical Trial
Official title:
Towards Better Prognostic and Diagnostic Strategies for Haemostatic Changes During Major Obstetric Haemorrhage
Major obstetric haemorrhage (MOH) remains a cause of significant maternal morbidity and
mortality worldwide. By identifying women with a higher a priori risk of major haemorrhage
during their pregnancy or early during postpartum haemorrhage extra measures to prevent MOH
can be taken.
In this study the investigators aim to identify haemostatic parameters that during the course
of haemorrhage are responsible for the on-going towards major bleeding. By doing this,
cut-off points can be defined for future interventions aiming to stop this bleeding process
in an early stage. Traditional coagulation parameters are currently not useful for clinical
decision making, because of long turn around times. Therefore the added value of available
coagulation 'point of care' tests will be evaluated during obstetric haemorrhage.These
Point-of-Care (POC) tests could lead to a goal-directed haemostatic therapy for obstetric
haemorrhage.
A cohort of 9.500 pregnant women will be followed during their pregnancy and delivery. From
all women a bleeding score will be obtained during their pregnancy by means of a validated
questionnaire. The predictive value of this bleeding score for the occurrence of major
obstetric haemorrhage will be evaluated.
If postpartum haemorrhage develops (blood loss) > 1000 cc, blood samples will be drawn for
conventional haemostatic parameters and ROTEM profiles. The pathway between minor bleeding
and major bleeding will be elucidated. Interchangeability and comparability of conventional
haemostatic parameters and ROTEM profiles will also be evaluated.
The overall goal of the investigators is becoming more able to predict major obstetric
haemorrhage in an early stage of postpartum haemorrhage and define thresholds for
goal-directed hemostatic therapies.
See 'brief summary' ;
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