OAA Medium Project Grant
The successful applicant for the OAA Medium Project Grant was:
Dr Rachel Collis
University Hospital of Wales
Title
Characterising the coagulopathy of postpartum haemorrhage (PPH)
Amount
£15,000
Scientific Abstract
The coagulopathy caused by postpartum haemorrhage (PPH) is not well defined and likely to differ from trauma-induced-coagulopathy. It is not known how PPH-induced-coagulopathies vary according to the cause of the bleeding or evolve as bleeding progresses and resuscitation is started. Treatment guidelines recommend that PPH should be treated with regimens designed for major trauma and advocate formulaic fixed-ratio RBC:FFP transfusion. This is unlikely to be the optimal treatment strategy for PPH and potentially causes harm because many women will receive FFP unnecessarily.
In this study we propose to recruit 100 women early during a PPH with a variety of PPH aetiologies and severity and monitor haemostasis at least every 30 minutes until the bleeding is controlled. These women will be compared with 25 term women who are not bleeding. We will monitor coagulation factors, global haemostatic assays and look for evidence of fibrinolysis, dysfibrinogenaemia, disseminated intravascular coagulation and activation of protein C. Data will be analysed according to the cause of bleeding. The effect of crystalloid and colloid infusions will be examined. The impact of haemostatic replacement with FFP and fibrinogen concentrate will be documented. These data will allow targeted and evidence-based strategies to be developed for the treatment of haemostatic impairment during PPH.
