{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T19:09:01Z","timestamp":1768072141836,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,6,19]],"date-time":"2021-06-19T00:00:00Z","timestamp":1624060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>To evaluate rotational fibrin\u2010based thromboelastometry (ROTEM<jats:sup>\u00ae<\/jats:sup> FIBTEM) with amplitude of clot firmness at 5\u00a0min (A5) as an early point\u2010of\u2010care parameter for predicting progression to severe postpartum hemorrhage, and compare its predictive value with that of fibrinogen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Prospective cohort study in the Netherlands including women with 800\u20131500\u00a0ml of blood loss within 24\u00a0h following birth. Blood loss was quantitatively measured by weighing blood\u2010soaked items and using a fluid collector bag in the operating room. Both FIBTEM A5\u00a0values and fibrinogen concentrations (Clauss method) were measured between 800 and 1500\u00a0 ml of blood loss. Predictive accuracy of both biomarkers for the progression to severe postpartum hemorrhage was measured by area under the receiver operating curves (AUC). Severe postpartum hemorrhage was defined as a composite endpoint of (1) total blood loss &gt;2000\u00a0ml, (2) transfusion of \u22654 packed cells, and\/or (3) need for an invasive intervention to cease bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 391 women included, 72 (18%) developed severe postpartum hemorrhage. Median (IQR) volume of blood loss at blood sampling was 1100\u00a0ml (1000\u20131300) with a median (interquartile range [IQR]) fibrinogen concentration of 3.9\u00a0g\/L (3.4\u20134.6) and FIBTEM A5\u00a0value of 17\u00a0mm (13\u201320). The AUC for progression to severe postpartum hemorrhage was 0.53 (95% confidence interval [CI] 0.46\u20130.61) for FIBTEM A5 and 0.58 (95% CI 0.50\u20130.65) for fibrinogen. Positive predictive values for progression to severe postpartum hemorrhage for FIBTEM A5 \u226412 mm was 22.5% (95% CI 14\u201333) and 50% (95% CI 25\u201375) for fibrinogen \u22642\u00a0g\/L.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The predictive value of FIBTEM A5 compared to fibrinogen concentrations measured between 800 and 1500\u00a0ml of blood loss following childbirth was poor to discriminate between women with and without progression towards severe postpartum hemorrhage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14172","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T14:51:15Z","timestamp":1621263075000},"page":"1656-1664","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Clinical value of early viscoelastometric point\u2010of\u2010care testing during postpartum hemorrhage for the prediction of severity of bleeding: A multicenter prospective cohort study in the Netherlands"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9753-3983","authenticated-orcid":false,"given":"Paul I.","family":"Ramler","sequence":"first","affiliation":[{"name":"Center for Clinical Transfusion Research Sanquin Research Leiden the Netherlands"},{"name":"Department of Obstetrics Leiden University Medical Center Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9586-276X","authenticated-orcid":false,"given":"Ada","family":"Gillissen","sequence":"additional","affiliation":[{"name":"Center for Clinical Transfusion Research Sanquin Research Leiden the Netherlands"},{"name":"Department of Obstetrics Leiden University Medical Center Leiden the Netherlands"},{"name":"Department of Clinical Epidemiology Leiden University Medical Center Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3164-8611","authenticated-orcid":false,"given":"Dacia D. C. A.","family":"Henriquez","sequence":"additional","affiliation":[{"name":"Center for Clinical Transfusion Research Sanquin Research Leiden the Netherlands"},{"name":"Department of Obstetrics Leiden University Medical Center Leiden the Netherlands"},{"name":"Department of Clinical Epidemiology Leiden University Medical Center Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3161-5684","authenticated-orcid":false,"given":"Camila","family":"Caram\u2010Deelder","sequence":"additional","affiliation":[{"name":"Center for Clinical Transfusion Research Sanquin Research Leiden the Netherlands"},{"name":"Department of Clinical Epidemiology Leiden University Medical Center Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander A.","family":"Markovski","sequence":"additional","affiliation":[{"name":"Center for Clinical Transfusion Research Sanquin Research Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7749-334X","authenticated-orcid":false,"given":"Moniek P. M.","family":"de Maat","sequence":"additional","affiliation":[{"name":"Department of Hematology Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3191-9362","authenticated-orcid":false,"given":"Johannes J.","family":"Duvekot","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3268-5759","authenticated-orcid":false,"given":"Jeroen C. J.","family":"Eikenboom","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Leiden University Medical Center Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1377-4625","authenticated-orcid":false,"given":"Kitty W. M.","family":"Bloemenkamp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Division Woman and Baby Birth Center Wilhelmina Children Hospital University Medical Center Utrecht Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4679-9028","authenticated-orcid":false,"given":"Jan M. M.","family":"van Lith","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9890-9145","authenticated-orcid":false,"given":"Thomas","family":"van den Akker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center Leiden the Netherlands"},{"name":"Athena Institute Faculty of Science VU University Medical Center Amsterdam the Netherlands"},{"name":"National Perinatal Epidemiology Unit University of Oxford Oxford United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9095-2475","authenticated-orcid":false,"given":"Johanna G","family":"van der Bom","sequence":"additional","affiliation":[{"name":"Center for Clinical Transfusion Research Sanquin Research Leiden the Netherlands"},{"name":"Department of Clinical Epidemiology Leiden University Medical Center Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60696-6"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2004.00101.x"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.01713.x"},{"issue":"133","key":"e_1_2_11_5_1","first-page":"e1","article-title":"Identification of severe maternal morbidity during delivery hospitalizations, United States, 1991\u20132003","volume":"199","author":"Callaghan WM","year":"2008","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12605"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2007.02297.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes096"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2010.12.002"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2018022632"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH08-06-0383"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes361"},{"issue":"1","key":"e_1_2_11_13_1","first-page":"v","article-title":"Viscoelastic point\u2010of\u2010care testing to assist with the diagnosis, management and monitoring of hemostasis: a systematic review and cost\u2010effectiveness analysis","volume":"19","author":"Whiting P","year":"2015","journal-title":"Health Technol Assess"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH08-06-0386"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02187.x"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-04-567891"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14178"},{"key":"e_1_2_11_18_1","unstructured":"Nederlandse Vereniging voor Obstetrie en Gynaecologie.Hemorrhagia postpartum (HPP). 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Diagnostics guidance Publisched: 20 August 2014."}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14172","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.14172","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14172","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T18:40:23Z","timestamp":1692816023000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14172"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,19]]},"references-count":32,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1111\/aogs.14172"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14172","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,19]]},"assertion":[{"value":"2021-01-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}