[Management of blood products in obstetric services]

Define the access conditions and mode of use of blood products in the context of the management of immediate postpartum hemorrhage.

This text is based on the guidelines published by the French National Authority for Health (HAS) and the French National Security Agency of Medicines and Health Products (ANSM) and a literature search in Medline and Cochrane Library databases.

Postpartum bleeding, often unpredictable and potentially severe, may represent a challenge for transfusion management decision within an institution. The efficiency of the decision is based on an emergency protocol widely available in each establishment to secure access to blood products, and coordination between teams of clinical and blood transfusion services (Professional consensus). Blood transfusion is not without infectious and immunological risks, each indication must be carefully considered based on clinical and laboratory criteria (Professional consensus). Availability of blood groups and antibody screening results must be checked upon entry to the delivery unit (Professional consensus). If bleeding risk is identified, RAI less than three days is recommended (Professional consensus). Complex immunological situations, including rare blood groups, should be planned and managed with EFS blood centers throughout prenatal period (Professional consensus).

Transfusion management in postpartum hemorrhage should be a multidisciplinary approach and requires mastery of emergency circuits to obtain promptly blood products.