title: Management of Coagulopathy in Postpartum Hemorrhage.
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.
authors.affiliation: Department of Obstetrics & Gynecology, Duke University, Durham, North Carolina.
authors.forename: Andra H
authors.initials: AH
authors.lastname: James
authors.affiliation: Department of Obstetrics & Gynecology, Duke University, Durham, North Carolina.
authors.forename: Chad
authors.initials: C
authors.lastname: Grotegut
authors.affiliation: Department of Obstetrics & Gynecology, George Washington University, Washington, District of Columbia.
authors.forename: Homa
authors.initials: H
authors.lastname: Ahmadzia
authors.affiliation: Department of Anesthesiology, Duke University, Durham, North Carolina.
authors.forename: Cathleen
authors.initials: C
authors.lastname: Peterson-Layne
authors.affiliation: Department of Pathology, University of New Mexico, Albuquerque, New Mexico.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Lockhart
mesh_terms: D001778:Blood Coagulation Disorders / Q000097:blood / Q000209:etiology / Q000517:prevention & control; D016913:Blood Component Transfusion; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000097:blood / Q000628:therapy; D011247:Pregnancy