Latest Evidence on Real-Time Blood Clotting Tests in Childbirth Emergencies

Postpartum hemorrhage, characterized by severe bleeding after childbirth, remains one of the leading causes of maternal mortality worldwide. Fortunately, advancements in blood-monitoring technology, such as viscoelastic testing (VET), offer promising prospects for improving maternal outcomes. While VET is established in some European medical centers, it has yet to become a standard practice in U.S. maternity care.

A comprehensive review conducted by the Southern California Evidence Review Center, affiliated with the Keck School of Medicine of USC, sheds light on VET’s potential application during childbirth. Published in the International Journal of Obstetric Anesthesia, the review analyzed 156 research articles, including interviews with patients, clinicians, and policymakers, to assess the current state of evidence.

VET is a minimally invasive bedside test that evaluates how quickly blood clots and identifies specific deficiencies. It provides rapid, detailed results within minutes, enabling healthcare providers to make real-time decisions about transfusions—whether blood components like platelets and plasma or whole blood—aimed at controlling hemorrhage. Currently, VET is approved by the FDA for use during cardiac surgery, orthopedic procedures, and trauma, but not yet for obstetric care.

The review highlighted that while VET shows significant promise, there is limited high-quality research, such as large-scale randomized controlled trials, specifically focused on pregnant women and postpartum hemorrhage. Experts emphasize the need for multi-center research within the U.S., standardized protocols, and consensus on best practices to fully integrate VET into obstetric care.

Adoption barriers include the costs associated with implementing VET systems, training clinicians, and establishing protocols for its use. Additionally, the lack of uniform guidelines on how and when to apply VET during childbirth further hampers widespread adoption.

Despite these challenges, the potential benefits extend beyond survival. VET can help conserve expensive blood products by tailoring transfusions, reduce health disparities—particularly for underserved populations such as Black women and those in rural areas—and improve overall maternal care. As research advances, many experts argue that the logic of adopting promising technologies like VET justifies their early use, even amid ongoing studies.

In summary, the integration of real-time blood clotting assessments in obstetric emergencies could revolutionize maternal care, significantly reducing preventable deaths and improving health outcomes in the U.S. and beyond.

For more detailed information, see the full review by C. Janzen et al. in the International Journal of Obstetric Anesthesia.

Source: https://medicalxpress.com/news/2025-09-major-highlights-latest-evidence-real.html