Strategies to reduce blood product utilization in obstetric practice

Area of Science:

• Obstetric Medicine
• Anesthesiology
• Hematology

Background:

• Patient blood management (PBM) optimizes patient outcomes and safety by minimizing unnecessary transfusions.
• PBM is standard in elective surgery but underutilized in obstetrics.
• Obstetric hemorrhage remains a significant cause of maternal morbidity and mortality.

Purpose of the Study:

• To review recent evidence on reducing blood product utilization in obstetric practice.
• To highlight the potential of PBM in obstetrics.
• To summarize effective strategies for managing anemia and coagulopathy in pregnancy.

Main Methods:

• Review of recent scientific findings and clinical evidence.
• Focus on strategies for anemia correction and hemorrhage management.
• Evaluation of blood conservation techniques in obstetric settings.

Main Results:

• Intravenous iron is safe and effective for treating iron deficiency anemia in pregnancy.
• Early administration of tranexamic acid and viscoelastic-guided coagulation factor management can control peripartum hemorrhage.
• Autologous red cell salvage for cesarean sections may reduce transfusion needs but is controversial.

Conclusions:

• Implementing PBM in obstetrics has significant potential to decrease blood loss and allogeneic transfusions.
• Intravenous iron supplementation can improve peripartum hemoglobin levels.
• Tranexamic acid and point-of-care guided coagulation factor therapy are key to reducing transfusion requirements in obstetrics.