Green, L, Knight, M, Seeney, F et al. (6 more authors) (2016) The haematological features and transfusion management of women who required massive transfusion for major obstetric haemorrhage in the UK: a population based study. British Journal of Haematology, 172 (4). pp. 616-624. ISSN 0007-1048
Abstract
Understanding the coagulopathy of major-obstetric-haemorrhage (MOH) that leads to massive-transfusion (MT) is fundamental to improving outcomes. This study reports on the haematological features and transfusion management of women experiencing MT [defined as transfusion of ≥8 units of red blood cells (RBC) within 24 h of delivery]. One hundred and eighty-one cases [median (interquartile range; IQR) age 33 years (29–36)] were identified from all UK hospitals, using the UK Obstetric Surveillance System between July 2012 and June 2013. The median (IQR) estimated blood loss was 6 l (4·5–8). At presentation, the median platelet count was lowest for placenta accreta, compared with other causes, while the median prothrombin time and fibrinogen were <1·5 × mean normal and <3 g/l, respectively for all aetiologies. Median platelet count and fibrinogen fell to <75 × 109/l and <2 g/l, respectively for all causes during bleeding, except for trauma. The median (IQR) units of RBC, fresh-frozen-plasma (FFP) and cryoprecipitate transfused were 10 (8–14), 6 (4–8) and 2 (2–4), respectively. The median time from the onset of bleeding to delivery of the first RBC unit was significantly shorter for women who delivered via elective caesarean section, compared with others. The coagulopathy of MT during MOH differs significantly depending on its cause, suggesting that more targeted transfusion strategies are required.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Keywords: | massive transfusion; obstetric haemorrhage; coagulopathy; outcomes; transfusion management |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Inst of Biomed & Clin Sciences (LIBACS) (Leeds) > Obstetrics & Gynaecology (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 04 May 2016 15:20 |
Last Modified: | 10 Jun 2016 18:50 |
Published Version: | http://dx.doi.org/10.1111/bjh.13864 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1111/bjh.13864 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:95879 |