Abstract
The purpose of this article is to review the use of blood products and hemostatic
agents in the management of coagulopathy at the time of postpartum hemorrhage. Blood
product administration strategies are broadly reviewed, including the role of the
blood bank, the role of massive transfusion protocols, the role of laboratory monitoring,
and the role of anesthesia management. Aspects of patient blood management are discussed.
The concept refers to an evidence-based, comprehensive, multidisciplinary approach
to optimizing the care of patients who might need transfusion and includes measures
to avoid or minimize transfusion such as preoperative anemia management, cell salvage,
and the use of hemostatic medication to reduce bleeding. The contributions of individual
blood components—red blood cells, plasma, cryoprecipitate, and platelets—are described.
Current data regarding the complementary role of hemostatic agents—antifibrinolytic
agents and clotting factor concentrates—are presented. Two developments in blood component
pathogen reduction are introduced.
Keywords
postpartum hemorrhage - coagulopathy - transfusion - patient blood management - blood
product - blood component
