Transfusion Therapy in Postpartum Hemorrhage

Postpartum hemorrhage (PPH) is an obstetric emergency that can occur following vaginal or cesarean delivery. Rapid diagnosis of PPH using laboratory and clinical parameters is an important first step in its management. Traditional blood components, including packed red blood cells, platelets, plasma, and cryoprecipitate, should be used in patients with significant bleeding. Recent studies underline the utility of transfusing these components in defined ratios to prevent dilutional coagulopathy. Disseminated intravascular coagulation (DIC) should be considered in severely bleeding obstetric patients and should be treated aggressively using blood components. Newer hemostatic agents, such as activated factor VII, will play significant roles in patients with bleeding that is refractory to standard therapy. Implementation of an obstetric bleeding protocol that integrates new knowledge in coagulation should aid physicians in improving outcomes for the mother and her fetus. Semin Perinatol 33:124-127 (C) 2009 Elsevier Inc. All rights reserved.