{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:47:37Z","timestamp":1783079257198,"version":"3.54.6"},"reference-count":28,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2024,11,3]],"date-time":"2024-11-03T00:00:00Z","timestamp":1730592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23HL141640"],"award-info":[{"award-number":["K23HL141640"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neonatal-Perinatal Medicine"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Inconsistency in defining postpartum hemorrhage (PPH), and the inability of current tools and approaches to accurately predict PPH have led to the exploration of innovative methods. Rotational thromboelastometry (ROTEM) point-of-care technology provides real-time assessment of the clotting process facilitating time-efficient hemostatic interventions. Our study investigates the utility of ROTEM parameters for predicting individual risk of PPH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multi-site, prospective observational cohort study recruited 92 women who underwent scheduled cesarean delivery and normal spontaneous vaginal delivery at university-affiliated hospitals from 2018 to 2023. We included women between 18 and 50\u00a0years old at \u226534\u00a0weeks of gestation. Subjects were approached in the hospital pre-admission testing unit during their routine pre-operative blood draws, typically at least 72\u00a0h in advance of their planned cesarean delivery. Participants were also enrolled at the hospital once they arrived for admission a few hours before their procedure. ROTEM parameters EXTEM clotting time (CT), clot formation time (CFT), alpha angle, A10, A20, maximum clot formation (MCF), maximum lysis, were measured preoperative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found significant effects of age, blood loss type, delivery mode, gestational age, and maximum lysis on blood loss. The reduced model predicted that every one-percent increase in maximum lysis was associated with a 44-milliliter increase in blood loss and every one-year increase in age was associated with a 19-milliliter increase in blood loss. On average, cesarean deliveries resulted in 522 more milliliters of blood loss than normal spontaneous vaginal delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The ROTEM EXTEM maximum lysis parameter has a significant effect on blood loss. Larger prospective clinical trials in conjunction with a prompt definition of the ranges of reference values will strengthen these advances to provide a rapid assessment and guide early interventions to prevent severe obstetric bleeding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19345798241291327","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T06:48:02Z","timestamp":1733208482000},"page":"18-24","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Correlation of predelivery Rotational Thromboelastometry readings with the risk of postpartum hemorrhage during delivery: The ROTEM Study"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8025-534X","authenticated-orcid":false,"given":"Joaquin A","family":"Calderon","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5551-7571","authenticated-orcid":false,"given":"Ahmed M","family":"Ebeid","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9897-3315","authenticated-orcid":false,"given":"Sean M","family":"Lee","sequence":"additional","affiliation":[{"name":"Office of Clinical Research, The George Washington University Medical Faculty Associates, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0341-1086","authenticated-orcid":false,"given":"Homa K","family":"Ahmadzia","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA"},{"name":"Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Inova Health System, Falls Church, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,11,3]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Trends in maternal mortality 2000 to 2020: estimates by WHO UNICEF UNFPA World Bank Group and UNDESA\/Population Division. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789240068759"},{"key":"e_1_3_3_3_2","unstructured":"Trost S Beauregard J Chandra G et al. Pregnancy-related deaths: data from maternal mortality review committees in 36 US States 2017-2019. 2017."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13174"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2022.100742"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/bioengineering10030386"},{"key":"e_1_3_3_7_2","first-page":"CD007871","article-title":"Thromboelastography (TEG) or thromboelastometry (ROTEM) to monitor haemostatic treatment versus usual care in adults or children with bleeding","author":"Wikkels\u00f8 A","year":"2016","unstructured":"Wikkels\u00f8 A, Wetterslev J, M\u00f8ller AM, et al. Thromboelastography (TEG) or thromboelastometry (ROTEM) to monitor haemostatic treatment versus usual care in adults or children with bleeding. Cochrane Database Syst Rev 2016; 2016: CD007871.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11206150"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes361"},{"issue":"5","key":"e_1_3_3_10_2","first-page":"518","article-title":"Effect of thromboelastography (TEG\u00ae) and rotational thromboelastometry (ROTEM\u00ae) on diagnosis of coagulopathy, transfusion guidance and mortality in trauma: descriptive systematic review","author":"Da LLT","year":"2014","unstructured":"Da LLT, Nascimento B, Shankarakutty AK, et al. Effect of thromboelastography (TEG\u00ae) and rotational thromboelastometry (ROTEM\u00ae) on diagnosis of coagulopathy, transfusion guidance and mortality in trauma: descriptive systematic review. Crit Care 2014; 18(5):518.","journal-title":"Crit Care"},{"issue":"6","key":"e_1_3_3_11_2","first-page":"412","article-title":"Point of care 20: coagulation monitoring using Rotem \u00ae Sigma and Teg \u00ae 6S","author":"Weber CF","year":"2018","unstructured":"Weber CF, Zacharowski K. Point of care 20: coagulation monitoring using Rotem \u00ae Sigma and Teg \u00ae 6S. Anasthesiol Intensivmed Notfallmed Schmerzther 2018; 53(6): 412\u2013424. Available from: https:\/\/www.thieme-connect.com\/products\/ejournals\/html\/10.1055\/s-0043-107755","journal-title":"Anasthesiol Intensivmed Notfallmed Schmerzther"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1076029618772336"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14265"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13765"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer158"},{"key":"e_1_3_3_16_2","first-page":"62","article-title":"Viscoelastic methods of blood clotting assessment - a multidisciplinary review","author":"Benes J","year":"2015","unstructured":"Benes J, Zatloukal J, Kletecka J. Viscoelastic methods of blood clotting assessment - a multidisciplinary review. Front Med 2015; 2: 62.","journal-title":"Front Med"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet480"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14882"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1515\/acm-2015-0006"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2016-0333"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2016-0009"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12023"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/aog.0000000000003565"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-04-567891"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000003499"},{"key":"e_1_3_3_26_2","first-page":"107602962311750","article-title":"Evaluating the association between fibrinogen and rotational thromboelastometry and the progression to severe obstetric hemorrhage","author":"Yurashevich M","year":"2023","unstructured":"Yurashevich M, Rosser M, Small M, et al. Evaluating the association between fibrinogen and rotational thromboelastometry and the progression to severe obstetric hemorrhage. Clin Appl Thromb Hemost 2023; 29: 10760296231175089.","journal-title":"Clin Appl Thromb Hemost"},{"issue":"11","key":"e_1_3_3_27_2","first-page":"1192","article-title":"Validation of postpartum hemorrhage admission risk factor stratification in a large obstetrics population","author":"Ruppel H","year":"2021","unstructured":"Ruppel H, Liu VX, Gupta NR, et al. Validation of postpartum hemorrhage admission risk factor stratification in a large obstetrics population. Am J Perinatol 2021; 38(11): 1192\u20131200. Available from: pmc\/articles\/PMC7688483\/","journal-title":"Am J Perinatol"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/2055552015599644"},{"key":"e_1_3_3_29_2","unstructured":"Rasp\u00e9 C Besch M Charitos EI et al. Rotational thromboelastometry for assessing bleeding complications and factor XIII deficiency in cardiac surgery patients. 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