Editor's key points
Thromboelastometry-guided, bleeding, blood loss, PPH, trauma
BLOOD LOSS, BLEEDING, POSTPARTUM HAEMORRHAGE, POSTPARTUM HAEMORRHAGE

Postpartum haemorrhage remains a leading cause of maternal morbidity and mortality frequently requiring massive transfusion.This RCT compared goal-directed therapy with standard care in the treatment of postpartum haemorrhage.Thromboelastometry-guided transfusion therapy resulted in reduced plasma transfusion and estimated blood loss in this pilot study.A thromboelastometry-guided treatment protocol led to reduced use of fresh frozen plasma or OctaplasLG®, and possibly diminished bleeding amongst patients with severe postpartum haemorrhage compared with a conventional coagulation testing guided approach.Larger randomised and controlled studies are necessary to assess the effects on red cell administration, morbidity, and mortality.Postpartum haemorrhage (PPH) remains among the leading causes of maternal mortality worldwide including in developed countries.Conventional coagulation tests, such as prothrombin time (PT), activated partial thromboplastin time (aPTT), and Clauss fibrinogen measurement, have limitations with regard to decision-making during active PPH: turnaround times are up to an hour and certain cut-off points for plasma transfusion based on PT and aPTT (usually 1.5 times the upper normal range) are derived from trauma settings.