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Rotational thromboelastometry (ROTEM) – the future of point of care testing in obstetrics?
  1. K S King,
  2. S Setty,
  3. K Thompson,
  4. A P McGlennan,
  5. A L Wright
  1. Departments of Anaesthesia and Obstetrics, Royal Free Hospital, London, UK


Introduction ROTEM is a point of care testing (POCT) device that provides rapid specific coagulation pathway assessment. The use of ROTEM is well established in liver and cardiac surgery, but not as yet in an Obstetric setting. Previous studies have reported ROTEM values in pregnancy and postpartum but not in active labour.

Methods Ethical approval was obtained. Healthy labouring women at term were recruited at the point of requiring blood tests or intravenous access. Exclusion criteria were pre-eclampsia, liver disease, haematological disorders and taking of coagulation altering drugs.

On the blood sample we performed ROTEM analysis, including EXTEM, INTEM and FIBTEM and routine laboratory analysis (Clauss method) for fibrinogen.

Results At the time of submission, data sets were complete on 30 women (table 1).

Abstract PMM.81 Table 1

Discussion POCT is able to provide results much earlier than equivalent routine laboratory assays and the use of ROTEM is increasing in many areas. This preliminary data represents the first time a normal range of ROTEM values has been described in labouring women. As we gain greater understanding of the values in normal and abnormal labour, it is envisaged that ROTEM will become key to effectively managing blood product replacement in major Obstetric haemorrhage.

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