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When and how should I transfuse during obstetric hemorrhage?
1Department of Anesthesiology & Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Mcgowan Institute for Regenerative Medicine, Pittsburgh, PA, USA.
International Journal of Obstetric Anesthesia
|April 27, 2021
Summary
Maternal hemorrhage and blood transfusions are rising. This review covers managing obstetric hemorrhage with goal-directed transfusion strategies and autotransfusion to improve patient outcomes.
Area of Science:
- Obstetrics and Gynecology
- Hematology
- Transfusion Medicine
Background:
- Rising incidence of maternal hemorrhage and blood transfusions.
- Massive hemorrhage defined as >10 units of erythrocytes.
- Common causes include abnormal placental insertion, preeclampsia, and placental abruption.
Purpose of the Study:
- To review transfusion practices for managing obstetric hemorrhage.
- To explore goal-directed transfusion approaches.
- To discuss autotransfusion as an alternative to allogeneic transfusion.
Main Methods:
- Literature review of transfusion practices in obstetric hemorrhage.
- Analysis of current management strategies, including ratio-based and goal-directed transfusion.
- Evaluation of autotransfusion techniques and benefits.
Main Results:
- Massive obstetric hemorrhage requires timely and effective management.
- Goal-directed transfusion using laboratory or point-of-care data may improve outcomes.
- Autotransfusion offers a method to mitigate risks associated with allogeneic blood.
Conclusions:
- Effective management of obstetric hemorrhage is critical.
- Goal-directed transfusion strategies and autotransfusion are important considerations.
- Further research into optimal transfusion practices is warranted.
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