Transfusion of red cells and coagulation products should be guided by point of care haemostatic tests (venous Hb/ ROTEM/ TEG) followed by lab tests.
POC coagulation testing (TEG/ ROTEM) allow rapid, real time, quantitative and qualitative data (available often < 30 minutes) which can be used by clinicians to guide coagulation product transfusion.
Fibrinogen concentrate use/replacement of fibrinogen should be considered early in obstetric bleeding (especially in specific circumstances such as placental abruption/ amniotic fluid embolus).
Specific measures for MOH include pharmacological, mechanical, surgical and radiological.
Post event debriefing is essential for both the patient/ birth partner and staff involved.
