Rotational Thromboelastometry (ROTEM) and Thromboelastography (TEG) are point-of-care techniques to assess real time coagulation and fibrinolysis in whole blood. The risk of coagulopathy markedly increases with bleeding > 2000 ml, showing the importance of these tests to guide management in MOH.
Advantages
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Rapid, real time, point of care quantitative and qualitative data (available often < 30 minutes) which can be used by clinicians to guide coagulation product transfusion.
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Can be repeated serially very easily and compared/ contrasted.
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Information on all steps in coagulation including clot growth and fibrinolysis.
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Rapid information on hypofibrinogenaemia and when to treat.
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Theoretical reduction in bleeding and use of transfusion products, and better outcome, however there is little RCT data to support this, especially in obstetrics.
