Tatyana A. Sushko
Snegirev Maternity Hospital No. 6, Russian FederationPresentation Title:
Pathogenetic approach to the treatment of coagulopathic bleeding in obstetrics
Abstract
A prospective cohort study was conducted involving 52 patients with
postpartum hemorrhage (PPH) who gave a child birth between 2021 and 2023.
Diagnostics and treatment of coagulopathy was carried out according to the
algorithm using thromboelastometry (TEM) parameters. Patients were divided into 3 groups
depending on blood loss volume: group 1 (n =
19) – blood loss up to 1499 ml; group 2 (n = 14) – blood loss from 1500 to 1999
ml; group 3 (n = 19) –blood loss 2000 ml and more. Statistically significant differences were found for the fibrinogen
level, MCF and A10 parameters on the FIBTEM channel depending on blood loss volume (p < 0.05), indicating a decrease in the
quality of fibrin clot upon with increasing blood loss. Highly tight direct relationships were found between the fibrinogen, MCF and A10
values, demonstrating that with a decrease in the fibrinogen level at the time of bleeding by 1.0 g/L, a decrease in MCF by 3.802
mm (the resulting model explains 64.3 % of the observed variance), and A10 by 3.497 mm (the resulting model explains 64.1 % of
the observed variance) should be expected. TEM parameters CT and CFT on the INTEM channel also correlated with
blood loss volume and had a significant direct correlation between noticeable
tightness (according to the Chaddock scale) between APTT and CT (ρ = 0.612; p < 0.001) as well as
moderate tightness between APTT and CFT (rxy = 0.44; p = 0.017).Based on controlled transfusion protocol, in group 1, in 57.9 % of cases it was possible apply no transfusion therapy. The use of the TEM method in the diagnostics
of hemostasis disorders with PPH allowed for the differential and short- term application of pathogenetically justified therapy with blood components
and preparations only in cases where it was required.
Biography
Tatyana Sushko graduated from the First Pavlov Medical University in Saint Petersburg in 2016. Since 2018, I completed residency in obstetrics and gynecology and I an obstetrician-gynecologist in the pregnancy pathology department and maternity ward in one of the oldest maternity hospitals in Russia, where care is provided to pregnant women with various severe pathologies, including congenital and acquired coagulopathy and thrombophilia. Since 2022, I have undergone additional professional training and is a doctor of ultrasound diagnostics. Since 2025, I have been a transfusionist. I am a postgraduate student at the Department of Obstetrics and Gynecology of the First Pavlov Medical University and am working on writing a PhD dissertation on the topic "Differentiated approach to the prevention and treatment of obstetric coagulopathic bleeding".
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