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THE USE OF PROTHROMBIN-COMPLEX WITH FIBRINOGEN CONCENTRATE FOR ROTEM®-GUIDED MANAGEMENT OF SEVERE COAGULOPATHY ASSOCIATED WITH MINOR PLACENTAL ABRUPTION
ŽIGA PODLIPNIK
; University Medical Centre Ljubljana, Department of Anesthesiology and Intensive Therapy, Ljubljana, Slovenia
NEJC UMEK
; University of Ljubljana, Faculty of Medicine, Institute of Anatomy, Ljubljana, Slovenia
GORAZD KAVŠEK
; University Medical Centre Ljubljana, Department of Perinatology, Division of Obstetrics and Gynecology, Ljubljana, Slovenia
IVA BLAJIĆ
; University Medical Centre Ljubljana, Department of Anesthesiology and Intensive Therapy, Ljubljana, Slovenia
TATJANA STOPAR PINTARIČ
orcid.org/0000-0003-2750-5386
; University Medical Centre Ljubljana, Department of Anesthesiology and Intensive Therapy, Ljubljana, Slovenia; University of Ljubljana, Faculty of Medicine, Institute of Anatomy, Ljubljana, Slovenia;
Abstract
Placental abruption can cause signifi cant hemorrhage and coagulopathy that can progress rapidly due to consumption and
depletion of clotting factors. Rapid detection and treatment of hypofi brinogenemia is essential in the evolving clinical and
hematologicmilieu. The use of ROTEM® allows a dynamic monitoring of coagulopathy. So far, only fi brinogen concentrate
has been described for prompt management of severe coagulopathy associated with placental abruption. We report a
case of a 40-year-old multipara with minor placental abruption complicated by severe coagulopathy, where a combination
of prothrombincomplex and fi brinogen concentrate was used for prompt treatment. Potential benefi ts and drawbacks of
prothrombin complex concentrate therapy, as well as diagnostic and therapeutic considerations of ROTEM® - guided test
are discussed.
Keywords
coagulopathy; placental abruption; prothrombin complex concentrate; fibrinogen concentrate; obstetric hemorrhage
Hrčak ID:
256997
URI
Publication date:
28.4.2021.
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