OB Hemorrhage: Blood Product Replacement

Larry Shields, MD, Rich Lee, MD, Maurice Druzin, MD, Jennifer McNulty MD, Holli Mason, MD

Central Coast Maternal Fetal Medicine-Obstetrics Medical Group; Division of Maternal Fetal Medicine, University of Southern California, Women’s & Children’s Hospital; Division of Maternal Fetal Medicine, Stanford University School of Medicine; Division of Maternal Fetal Medicine, University of California, Irvine; Transfusion Medicine and Serology, Harbor UCLA Medical Center

 

Summary

This report covers the new science of massive transfusion protocols. Lessons from military trauma units in Iraq as well as civilian experience with motor vehicle accidents and massive obstetric hemorrhage have identified new principles such as prominent use of fresh frozen plasma (FFP) and resuscitation transfusion without waiting for laboratory results. Nine massive hemorrhage protocols tailored specifically to obstetrics were evaluated and reported three primary problems: 1) delayed diagnosis, 2) underestimated blood loss, and 3) prevention and/or treatment of fulminate disseminated intravascular coagulation (DIC)

(Download or Print Full Document)