Obstetric Anaesthesia Annual Scientific Meeting 2025

Introduction of ROTEM + Fibrinogen Concentrate to a District General Hospital Obstetric Service. Impact on blood product usage – A 2-year experience.

Background

-Victoria Hospital, Scotland is a medium sized DGH with approximately 3000 births per year (across consultant led and midwifery led units).

-Major Obstetric Haemorrhage (MOH) is a significant contributor to maternal morbidity and can be exacerbated by haemostatic impairment.

-National standards recommend that haemostatic resuscitation in MOH is guided by point of care coagulation devices (e.g. ROTEM Sigma).

-Fibrinogen deficiency is the commonest coagulation abnormality identified by ROTEM.

Method

-In May 2023, a ROTEM ® machine was introduced. This was supported by staff training and a transfusion protocol.

-Since its introduction, ongoing work has led to additional improvement measures, such as the introduction of fibrinogen concentrate.

-Data on MOH rates and blood product usage was collected over a 12-month period (May 22-May 23, Period 1).

-Data was recollected after introduction of ROTEM analyser, standardised transfusion protocol and fibrinogen concentrate (Aug 23-Aug 24, Period 2).

Introduction of point of care coagulation testing and impact on blood product usage: two year experience of a District General Obstetric service