Blood Product Replacement for Postpartum Hemorrhage

Authors: Eid, J; Stahl, D

Affiliations: Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Ohio State University Wexner Medical Center; Division of Critical Care Medicine, Department of Anesthesiology, Ohio State University, Columbus, OH, United States

Publication: Clinical obstetrics and gynecology; 2022

Abstract: Consideration for blood products replacement in postpartum hemorrhage should be given when blood loss exceeds 1.5 L or when an estimated 25% of blood has been lost. In cases of massive hemorrhage, standardized transfusion protocols have been shown to improve maternal morbidity and mortality. Most protocols recommend a balanced transfusion involving a 1:1:1 ratio of packed red blood cells, platelets, and fresh frozen plasma. Alternatives such as cryoprecipitate, fibrinogen concentrate, and prothrombin complex concentrates can be used in select clinical situations. Although transfusion of blood products can be lifesaving, it does have associated risks.