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Semin Thromb Hemost 2016; 42(07): 724-731
DOI: 10.1055/s-0036-1593417
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of Coagulopathy in Postpartum Hemorrhage

Andra H. James
1   Department of Obstetrics & Gynecology, Duke University, Durham, North Carolina
,
Chad Grotegut
1   Department of Obstetrics & Gynecology, Duke University, Durham, North Carolina
,
Homa Ahmadzia
2   Department of Obstetrics & Gynecology, George Washington University, Washington, District of Columbia
,
Cathleen Peterson-Layne
3   Department of Anesthesiology, Duke University, Durham, North Carolina
,
Evelyn Lockhart
4   Department of Pathology, University of New Mexico, Albuquerque, New Mexico
› Author Affiliations
Further Information

Publication History

Publication Date:
03 October 2016 (online)

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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
 

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