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Emergency cesarean section in glanzmann thrombasthenia: Anaesthetic management without recombinant factor VIIa.
Saudi J Anaesth
June 2023
Department of Anaesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Glanzmann thrombasthenia (GT) is a congenital disorder inherited autosomal recessively, caused by deficiency of platelet membrane glycoprotein IIb-IIIa complex leading to defective platelet aggregation, and manifesting as mucocutaneous bleeding. Parturients with GT requiring emergency cesarean section are at high risk for perioperative bleeding complications. The anesthetist should be prepared with the necessary measures to control bleeding.
View Article and Find Full Text PDFThe role of point of care thromboelastography (TEG) and thromboelastometry (ROTEM) in management of Primary postpartum haemorrhage: A meta-analysis and systematic review.
Saudi J Anaesth
January 2023
Department of Anesthesia, and Critical Care, AIIMS, Bhubaneswar, Odisha, India.
Article Synopsis
- - The study investigates the effectiveness of point-of-care viscoelastic tests for assessing coagulation during primary postpartum hemorrhage (PPH) compared to traditional empirical blood transfusion methods.
- - Analysis of five studies involving 1914 patients showed that viscoelastic-guided transfusion significantly reduces risks of complications such as emergency hysterectomy and circulatory overload, while also lowering the need for additional blood products.
- - While results indicate improved morbidity outcomes with viscoelastic testing, further research is needed to determine optimal transfusion thresholds, long-term patient survival, and overall cost-effectiveness.
A Case Report of Rotational Thromboelastometry-Assisted Decision Analysis for Two Pregnant Patients With Platelet Storage Pool Disorder.
A A Pract
February 2023
From the Departments of Anesthesiology, Perioperative and Pain Medicine.
Platelet storage pool disorders (PSPDs) constitute a diverse group of hematologic abnormalities, which share the common feature of a deficiency in the ability of platelets to aggregate. Parturients with PSPD can present management challenges to their care team when they present for childbirth, especially with regard to neuraxial anesthesia. We report a series of 2 deliveries from unrelated patients affected by PSPD.
View Article and Find Full Text PDFThromboelastometry-guided treatment algorithm in postpartum haemorrhage: a randomised, controlled pilot trial.
Br J Anaesth
February 2023
Department of Emergency Medicine, Pain Medicine and Anaesthesiology, Tampere University Hospital, Tampere, Finland; Faculty of Medicine and Health Technology, Tampere University Hospital, Tampere, Finland.
Background: Postpartum haemorrhage causes significant mortality among parturients. Early transfusion of blood products based on clinical judgement and conventional coagulation testing has been adapted to the treatment of postpartum haemorrhage, but rotational thromboelastometry (ROTEM) may provide clinicians means for a goal-directed therapy to control coagulation. We conducted a parallel design, randomised, controlled trial comparing these two approaches.
View Article and Find Full Text PDFThromboelastometry guiding anesthetic and coagulation management of cesarean delivery in a parturient with factor V deficiency.
Int J Obstet Anesth
November 2022
Obstetric Anesthesia and Intensive Care Unit, Hassan II University Hospital, Fez, Morocco.
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