Postpartum hemorrhage: Management of massive transfusion

Daneil L. Jackson, Thomas G. Deloughery

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations

Abstract

In women with postpartum hemorrhage, the need to transfuse a large amount of blood products is frequent. The ABCD of massive transfusions - Assessment/Activation, Blood products, Complications, and Drugs - can help manage this complex situation. There needs to be a defined method to activate the massive transfusion protocol and a well-defined means to assess the coagulation status of the patient by either traditional laboratory tests or point of care methods such as thromboelastography. Recent data supports more aggressive use of plasma in the massively transfused patient. Obstetricians need to be vigilant in assessing compilations, especially hypothermia. Given the increased use of antithrombotic drugs in bleeding patients, one needs to consider reversal of these agents. Finally, consideration of the role of other agents such as antifibrinolytic agents in the management of the bleeding patient is important. It is important for every hospital to have a well-defined massive transfusion protocol to streamline the care of postpartum hemorrhage. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After completing this activity, the learner should be better able to have a systematic approach to massive transfusions in postpartum hemorrhage, describe recent clinical trials on more aggressive use of plasma and tranexamic acid, and effectively monitor coagulation and for complications of massive transfusion.

Original languageEnglish (US)
Pages (from-to)418-422
Number of pages5
JournalObstetrical and Gynecological Survey
Volume73
Issue number7
DOIs
StatePublished - Jul 1 2018
Externally publishedYes

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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