Viscoelastic Testing Could Improve Treatment of Maternal Hemorrhage

Postpartum hemorrhage, severe bleeding after childbirth, remains one of the leading causes of maternal mortality worldwide, yet many of these deaths are preventable. Standard care can be hindered by delays in identifying the type of transfusion needed to stop bleeding. Now, a real-time blood-monitoring approach has shown potential to provide rapid, detailed insights into clotting, bringing hospitals closer to faster and more effective emergency care.

Researchers from the Keck School of Medicine of USC (Los Angeles, CA, USA) conducted a comprehensive review of viscoelastic testing (VET), a minimally invasive diagnostic technology. VET detects how well blood is clotting and identifies which blood components—such as plasma, platelets or whole blood—are most effective for treating hemorrhage. Already approved by the U.S. FDA for use in surgeries and trauma, the test is not yet standard in maternity care.

Image: New evidence shows viscoelastic testing can improve assessment of blood clotting during postpartum hemorrhage (Photo courtesy of 123RF)

The review analyzed findings from 156 studies and included interviews with patients, providers and policymakers. Evidence suggests VET can improve management of postpartum hemorrhage, but only two randomized controlled trials were identified, highlighting the need for stronger data. The review, published in the International Journal of Obstetric Anesthesia, underscores that large-scale U.S.-based research is essential to confirm its clinical impact in maternity settings.

Adopting VET could reduce maternal deaths and improve precision in transfusion practices, preventing unnecessary use of costly whole blood products. Its potential extends beyond survival benefits, with implications for reducing health disparities, as Black women and women in rural areas face higher maternal mortality rates. Researchers recommend multicenter randomized trials and standardized protocols to guide adoption, ensuring VET is implemented effectively in obstetric care.

“Because it is a point-of-care test that can be done at a patient’s bedside, it provides fast and detailed results within minutes, helping physicians make treatment decisions in real time,” said Carla Janzen, MD, PhD, first author of the publication.

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Keck School of Medicine of USC