| |
COAGULOPATHY (CLOTTING FAILURE)
Coagulopathy is both a cause and a result of massive obstetric
haemorrhage. It can be triggered by many causes, including:
| :: |
Abruption |
| :: |
Sepsis |
| :: |
Fetal
death |
| :: |
Eclampsia |
| :: |
Amniotic
fluid embolism. |
The clinical picture ranges from major haemorrhage, with or without thrombotic
complications, to a clinically stable state that can be detected only by
laboratory testing.
In many cases of acute blood loss, the development of coagulopathy can be prevented
if blood volume is restored promptly by infusion of IV fluids.
| 1 |
Treat
the possible cause of coagulation failure. |
| 2 |
Use
blood products to help control haemorrhage. |
| 3 |
Give
fresh whole blood, if available, to replace coagulation
factors and red cells. |
| 4 |
If
fresh whole blood is not available, choose one of the
following based on availability:
| • |
Fresh
frozen plasma or cryoprecipitate for replacement
of coagulation factors |
| • |
Packed
red cells for red cell replacement |
| • |
Platelet
concentrates (if bleeding continues and the platelet
count is
less than 20 000). |
|
For
further details refer to The Clinical Use of Blood (WHO,
2001, pages 223–224).
|
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