title: Postpartum hemorrhage and transfusion of blood and blood components.
abstract: Postpartum hemorrhage (PPH) is one of the top 5 causes of maternal mortality in developed and developing countries. The incidence of PPH is 40% after vaginal delivery and 30% after cesarean section. Criteria for PPH are based on the amount of blood loss. In clinical obstetrics, exact measurement of blood loss is often difficult. The most important treatment of PPH is red blood cell (RBC) transfusion. In the past few years, increasing concern has arisen about this treatment. Despite the introduction of several new guidelines, transfusion criteria still vary widely between clinicians. The decision whether to prescribe RBC transfusion is mostly based on postpartum hemoglobin (Hb) values. RBC transfusion should be aimed to reduce morbidity and especially to improve health-related quality of life (HRQoL). In this review, etiology, epidemiology, treatment, and prevention of postpartum hemorrhage are described. Special attention is given to the role of RBC transfusion in the treatment of PPH and the effects of RBC transfusion on HRQoL.
  
  
  BACKGROUND
  Obstetricians & Gynecologists, Family Physicians.
  
  
  OBJECTIVE
  After completion of this article, the reader should be able to summarize the new guidelines related to transfusion criteria, explain the importance of reducing morbidity related to improving quality of life issues, and list infectious and noninfectious complications of a red blood cell transfusion.
authors.affiliation: Sanquin Blood Bank South West Region, Rotterdam, The Netherlands.
authors.forename: A J G
authors.initials: AJ
authors.lastname: Jansen
authors.forename: D J
authors.initials: DJ
authors.lastname: van Rhenen
authors.forename: E A P
authors.initials: EA
authors.lastname: Steegers
authors.forename: J J
authors.initials: JJ
authors.lastname: Duvekot
mesh_terms: D001803:Blood Transfusion; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D017713:Platelet Transfusion; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D049590:Postpartum Period / Q000502:physiology; D011247:Pregnancy; D011788:Quality of Life; D012307:Risk Factors