Haematological and fibrinolytic status of Nigerian women with post-partum haemorrhage.

Journal: BMC pregnancy and childbirth

Volume: 18

Issue: 1

Year of Publication: 2019

Affiliated Institutions:  Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WCE HT, UK. Ian.roberts@lshtm.ac.uk. Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London, WCE HT, UK. Department of Obstetrics & Gynaecology, National Institute of Maternal and Child Health, College of Medicine, University of Ibadan, Orita-Mefa, Ibadan, Nigeria. Department of Chemical Pathology, College of Medicine, University of Ibadan, Orita-Mefa, Ibadan, Nigeria. Department of Obstetrics & Gynaecology, College of Medicine, University of Ibadan, Orita-Mefa, Ibadan, Nigeria. Department of Haematology, College of Medicine, University of Ibadan, Orita-Mefa, Ibadan, Nigeria. Thrombosis & Haemophilia Centre, Guy's & St Thomas' Trust, St Thomas' Hospital, Lambeth Palace Road, London, UK.

Abstract summary 

Early treatment with tranexamic acid reduces deaths due to bleeding after post-partum haemorrhage. We report the prevalence of haematological, coagulation and fibrinolytic abnormalities in Nigerian women with postpartum haemorrhage.We performed a secondary analysis of the WOMAN trial to assess laboratory data and rotational thromboelastometry (ROTEM) parameters in 167 women with postpartum haemorrhage treated at University College Hospital, Ibadan, Nigeria. We defined hyper-fibrinolysis as EXTEM maximum lysis (ML) > 15% on ROTEM. We defined coagulopathy as EXTEM clot amplitude at 5 min (A5) < 40 mm or prothrombin ratio > 1.5.Among the study cohort, 53 (40%) women had severe anaemia (haemoglobin< 70 g/L) and 17 (13%) women had severe thrombocytopenia (platelet count < 50 × 10/L). Thirty-five women (23%) had ROTEM evidence of hyper-fibrinolysis. Based on prothrombin ratio criteria, 16 (12%) had coagulopathy. Based on EXTEM A5 criteria, 49 (34%) had coagulopathy.Our findings suggest that, based on a convenience sample of women from a large teaching hospital in Nigeria, hyper-fibrinolysis may commonly occur in postpartum haemorrhage. Further mechanistic studies are needed to examine hyper-fibrinolysis associated with postpartum haemorrhage. Findings from such studies may optimize treatment approaches for postpartum haemorrhage.The Woman trial was registered: NCT00872469; ISRCTN76912190 (Registration date: 22/03/2012).

Authors & Co-authors:  Roberts Ian I Shakur Haleema H Fawole Bukola B Kuti Modupe M Olayemi Oladapo O Bello Adenike A Ogunbode Olayinka O Kotila Taiwo T Aimakhu Chris O CO Olutogun Tolulase T Hunt Beverley J BJ Huque Sumaya S

Study Outcome 

Source Link: Visit source

Statistics
Citations :  CRASH-2 trial collaborators. Shakur H, Roberts I, Bautista R, Caballero J, Coats T, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010;376(9734):23–32. doi: 10.1016/S0140-6736(10)60835-5.
Authors :  12
Identifiers
Doi : 143
SSN : 1471-2393
Study Population
Women
Mesh Terms
Adolescent
Other Terms
Coagulation;Fibrinolysis;Postpartum haemorrhage
Study Design
Cross Sectional Study
Study Approach
Country of Study
Mali
Publication Country
England