title: Pathology Consultation on Viscoelastic Studies of Coagulopathic Obstetrical Patients.
abstract: OBJECTIVE
  In obstetrics, the decision to transfuse blood components has historically been driven by traditional laboratory testing in combination with direct observation of bleeding. The adjunctive use of viscoelastic testing, including thromboelastometry and thromboelastography, has gained increasing acceptance in the clinical domain.
  
  
  METHODS
  We performed a review of the published medical literature by searching the PUBMED database for keywords "viscoelastic" and "obstetric," as well as "viscoelastic" and "postpartum hemorrhage." Additionally, case reports and expert opinion publications that referenced viscoelastic studies in obstetrical patients were evaluated.
  
  
  RESULTS
  There is very little high-quality evidence currently published in the medical literature to support the notion that viscoelastic testing obviates the need for traditional coagulation testing or improves mortality resulting from major obstetrical hemorrhage.
  
  
  CONCLUSIONS
  Additional research is needed to further focus the optimum role of viscoelastic tests in major obstetrical hemorrhage.
authors.affiliation: From the Department of Laboratory Medicine, Yale University, New Haven, CT; eric.gehrie@yale.edu.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Gehrie
authors.affiliation: From the Department of Laboratory Medicine, Yale University, New Haven, CT;
authors.forename: Ian
authors.initials: I
authors.lastname: Baine
authors.affiliation: Department of Pathology, Microbiology and Immunology, Vanderbilt University, Nashville, TN.
authors.forename: Garrett S
authors.initials: GS
authors.lastname: Booth
mesh_terms: D000328:Adult; D001778:Blood Coagulation Disorders / Q000175:diagnosis*; D001780:Blood Coagulation Tests / Q000379:methods*; D005260:Female; D006801:Humans; D010336:Pathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D012017:Referral and Consultation; D013916:Thrombelastography / Q000379:methods
keywords: Clinical pathology; Coagulation; Hematology; Transfusion medicine