Postpartum haemorrhage related early increase in D-dimers is inhibited by tranexamic acid: haemostasis parameters of a randomized controlled open labelled trial

Ducloy-Bouthors, A.-S.; Duhamel, Alain; Kipnis, Éric; Tournoys, Antoine; Prado-Dupont, A; Elkalioubie, Ahmed; Jeanpierre, Emmanuelle; Debize, G; Peynaud-Debayle, Edith; DeProst, D; Huissoud, Cyril; Rauch, Antoine; Susen, Sophie

doi:10.1093/bja/aew021

Cited by 64 publications

(54 citation statements)

References 39 publications

(57 reference statements)

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“…The working group of Ducloy-Bouthors [50] showed that the therapeutic application of TxA in bleeding PPH patients caused a significant reduction of blood loss, of patients with a haemoglobin decrease > 4 g/dl, a reduction of the number of transfused RBCs and a shorter bleeding duration. Analysing these study's haemostasis parameter provided biological evidence of an early increase in D-dimers and plasmin-antiplasmin complexes associated with active PPH and its attenuation by the early use of TxA [51]. The publication of the WOMAN (World Maternal Antifibrinolytic) trial will hopefully add further knowledge concerning the combination of TxA and PPH [52].…”

Section: Haemostasis and Coagulation Managementmentioning

confidence: 94%

Peripartum Haemorrhage: Haemostatic Aspects of the New German PPH Guideline

Lier

Heymann

Korte

et al. 2017

Transfus Med Hemother

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Peripartum haemorrhage remains one of the main causes of maternal mortality world-wide. The German, Austrian and Swiss Societies of Gynaecology and Obstetrics have updated the current guidelines for the treatment of peripartum haemorrhage together with the German Society of Anaesthesiology and Intensive Care Medicine and the Society of Thrombosis and Haemostasis Research. The recommendations have been the result of a thorough review of the available scientific literature and a consensus process involving all members of the guideline group. A key element of the anaesthesiological and haemostatic management is the development of a multidisciplinary standard operating procedure combining surgical as well as medical and haemostatic treatments depending on the severity of bleeding. The guideline underscores the value of clinical and laboratory diagnostics of peripartum haemorrhage as early as possible, even pre-emptively. This allows for an early identification of causes of bleeding and a specific treatment. The guideline comprises evidence-based recommendations for the use of uterotonics, tranexamic acid and blood products such as factor concentrates, fresh frozen plasma, platelet concentrates, packed red blood cells, recombinant activated factor VII and desmopressin. In addition, recommendations for blood conservation strategies involving the use of cell salvage, permissive hypotension and transfusion triggers are given.

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Section: Haemostasis and Coagulation Managementmentioning

confidence: 94%

Peripartum Haemorrhage: Haemostatic Aspects of the New German PPH Guideline

Lier

Heymann

Korte

et al. 2017

Transfus Med Hemother

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“…Increased fibrinolysis and platelet activation are observed, as well as a substantial release of tissue factor into the maternal blood stream, which may also activate consumption of procoagulant factors (12). Tranexamic acid administration has been shown to stabilize fibrinolysis and D-dimer liberation in obstetric hemorrhage and may be wellsuited to counter some aspects of the disproportional coagulopathy (13). Prior to publication of the WOMAN trial, several small, randomized trials were conducted on the prophylactic use of tranexamic acid in the setting of cesarean delivery at low-risk for hemorrhage.…”

Section: Editorialmentioning

confidence: 99%

The expanding role of tranexamic acid in the management of obstetric hemorrhage

Sullivan¹

2017

J. Thorac. Dis.

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“…[8][9][10] Typically, additional treatment includes antifibrinolytic therapy given the increased fibrinolysis in general associated with hemorrhage from the mucosal uterine surface. 11 Also, data are accruing in favor of antifibrinolytic therapy, 12 as a blood-conserving agent particularly in surgery 13,14 and in menorrhagia.…”

Section: Introductionmentioning

confidence: 99%