Patient blood management to minimize transfusions during the postpartum period.

Patient blood management is an evidence-based concept that seeks to minimize blood loss by maintaining adequate hemoglobin levels and optimizing hemostasis during surgery. Since the coronavirus disease 2019 pandemic, patient blood management has gained significance due to fewer blood donations and reduced amounts of blood stored for transfusion. Recently, the prevalence of postpartum hemorrhage (PPH), as well as the frequency of PPH-associated transfusions, has steadily increased. Therefore, proper blood transfusion is required to minimize PPH-associated complications while saving the patient's life. Several guidelines have attempted to apply this concept to minimize anemia during pregnancy and bleeding during delivery, prevent bleeding after delivery, and optimize recovery methods from anemia. This study systematically reviewed various guidelines to determine blood loss management in pregnant women.

[1]  Michel Clement,et al.  The impact of COVID-19 on blood donations , 2022, PloS one.

[2]  A. Butwick,et al.  Latest advances in postpartum hemorrhage management. , 2022, Best practice & research. Clinical anaesthesiology.

[3]  Anemia in Pregnancy: ACOG Practice Bulletin, Number 233. , 2021, Obstetrics and gynecology.

[4]  Jong Hoon Park,et al.  Making patient blood management the new norm(al) as experienced by implementors in diverse countries , 2021, BMC Health Services Research.

[5]  J. Waters,et al.  When and how should I transfuse during obstetric hemorrhage? , 2021, International journal of obstetric anesthesia.

[6]  Jong Hoon Park,et al.  Effect of patient blood management system and feedback programme on appropriateness of transfusion: An experience of Asia's first Bloodless Medicine Center on a hospital basis , 2020, Transfusion medicine.

[7]  Pattarawalai Talungchit,et al.  Economic evaluation of carbetocin as prophylaxis for postpartum hemorrhage in the Philippines , 2020, BMC Health Services Research.

[8]  Y. Vial,et al.  Patient blood management (PBM) in pregnancy and childbirth: literature review and expert opinion , 2019, Archives of Gynecology and Obstetrics.

[9]  S. Han,et al.  Predicting peripartum blood transfusion: focusing on pre-pregnancy characteristics , 2019, BMC Pregnancy and Childbirth.

[10]  Y. Chao,et al.  Carbetocin for the Prevention of Post-Partum Hemorrhage: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines , 2019 .

[11]  J. Freedman,et al.  Multimodal Patient Blood Management Program Based on a Three-pillar Strategy: A Systematic Review and Meta-analysis , 2019, Annals of surgery.

[12]  C. Samama,et al.  Patient blood management in obstetrics: prevention and treatment of postpartum haemorrhage. A NATA consensus statement. , 2019, Blood transfusion = Trasfusione del sangue.

[13]  P. Foral,et al.  Postpartum Invasive Group A Streptococcus Infection: Case Report and Mini-review , 2018, Cureus.

[14]  N. Hodyl,et al.  Treatment of iron deficiency and iron deficiency anemia with intravenous ferric carboxymaltose in pregnancy , 2018, Archives of Gynecology and Obstetrics.

[15]  C. Samama,et al.  Patient blood management in obstetrics: management of anaemia and haematinic deficiencies in pregnancy and in the post‐partum period: NATA consensus statement , 2018, Transfusion medicine.

[16]  P. Meybohm,et al.  Patient Blood Management improves outcome in oncologic surgery , 2017, Zeitschrift für Gastroenterologie.

[17]  J. Hamdorf,et al.  Improved outcomes and reduced costs associated with a health‐system–wide patient blood management program: a retrospective observational study in four major adult tertiary‐care hospitals , 2017, Transfusion.

[18]  A. Denys,et al.  Short & long term adverse outcomes after arterial embolisation for the treatment of postpartum haemorrhage: a systematic review , 2017, European Radiology.

[19]  M. Nel,et al.  The role of carbetocin in the prevention and management of postpartum haemorrhage. , 2016, International journal of obstetric anesthesia.

[20]  J. Isbister,et al.  Patient blood management: the global view , 2016, Transfusion.

[21]  B. Seifert,et al.  Implementation of a patient blood management monitoring and feedback program significantly reduces transfusions and costs , 2015, Transfusion.

[22]  K. Huybrechts,et al.  Patterns of Second-Line Uterotonic Use in a Large Sample of Hospitalizations for Childbirth in the United States: 2007-2011 , 2015 .

[23]  P. Toledo,et al.  Cell Salvage in Obstetrics , 2015, Anesthesia and analgesia.

[24]  B. Seifert,et al.  Patient blood management in cardiac surgery results in fewer transfusions and better outcome , 2015, Transfusion.

[25]  A. Weeks,et al.  Active versus expectant management for women in the third stage of labour. , 2015, The Cochrane database of systematic reviews.

[26]  L. Shields,et al.  Comprehensive maternal hemorrhage protocols reduce the use of blood products and improve patient safety. , 2015, American journal of obstetrics and gynecology.

[27]  G. Hofmeyr,et al.  Controlled cord traction for the third stage of labour. , 2015, The Cochrane database of systematic reviews.

[28]  T. Palihawadana,et al.  Iron deficiency anaemia in pregnancy: diagnosis, prevention and treatment , 2014 .

[29]  K. Huybrechts,et al.  Patterns of Second-Line Uterotonic Use in a Large Sample of Hospitalizations for Childbirth in the United States: 2007–2011 , 2014, Anesthesia and analgesia.

[30]  G. Draisci,et al.  Acute Lung Injury Complicating Blood Transfusion in Post-Partum Hemorrhage: Incidence and Risk Factors , 2014, Mediterranean journal of hematology and infectious diseases.

[31]  G. Escobar,et al.  Trends in red blood cell transfusion and 30‐day mortality among hospitalized patients , 2014, Transfusion.

[32]  T. Hernandez-Boussard,et al.  Restrictive blood transfusion practices are associated with improved patient outcomes , 2014, Transfusion.

[33]  Özge Tunçalp,et al.  Global causes of maternal death: a WHO systematic analysis. , 2014, The Lancet. Global health.

[34]  C. Gerber,et al.  Patient blood management in orthopaedic surgery: a four-year follow-up of transfusion requirements and blood loss from 2008 to 2011 at the Balgrist University Hospital in Zurich, Switzerland. , 2014, Blood transfusion = Trasfusione del sangue.

[35]  N. Hodyl,et al.  Intravenous ferric carboxymaltose for anaemia in pregnancy , 2014, BMC Pregnancy and Childbirth.

[36]  S. Arulkumaran,et al.  Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review , 2014, BJOG : an international journal of obstetrics and gynaecology.

[37]  Z. Alfirevic,et al.  Treatment for primary postpartum haemorrhage. , 2014, The Cochrane database of systematic reviews.

[38]  Gretchen A. Stevens,et al.  Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data , 2013, The Lancet. Global health.

[39]  H. Gombotz,et al.  Patient Blood Management , 2013, Der Anaesthesist.

[40]  G. Hofmeyr,et al.  Uterine massage for preventing postpartum haemorrhage. , 2013, The Cochrane database of systematic reviews.

[41]  P. Wouters,et al.  Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology. , 2013, European journal of anaesthesiology.

[42]  M. Gissler,et al.  Risk factors for blood transfusion at delivery in Finland , 2013, Acta obstetricia et gynecologica Scandinavica.

[43]  João Paulo Souza,et al.  A Systematic Review of the Relationship between Blood Loss and Clinical Signs , 2013, PloS one.

[44]  W. Callaghan,et al.  Severe Maternal Morbidity Among Delivery and Postpartum Hospitalizations in the United States , 2012, Obstetrics and gynecology.

[45]  Lily S Lee,et al.  Trends in postpartum hemorrhage from 2000 to 2009: a population-based study , 2012, BMC Pregnancy and Childbirth.

[46]  K. Sung,et al.  Primary postpartum hemorrhage: outcome of pelvic arterial embolization in 251 patients at a single institution. , 2012, Radiology.

[47]  G. Hofmeyr,et al.  Prostaglandins for preventing postpartum haemorrhage. , 2012, The Cochrane database of systematic reviews.

[48]  A. Peitzman,et al.  Hypothermia in massive transfusion: Have we been paying enough attention to it? , 2012, The journal of trauma and acute care surgery.

[49]  C. Radon,et al.  Increasing trends in atonic postpartum haemorrhage in Ireland: an 11‐year population‐based cohort study , 2012, BJOG : an international journal of obstetrics and gynaecology.

[50]  M. Druzin,et al.  Postpartum hemorrhage treated with a massive transfusion protocol at a tertiary obstetric center: a retrospective study. , 2012, International journal of obstetric anesthesia.

[51]  C. Colin,et al.  Association between fibrinogen level and severity of postpartum haemorrhage: secondary analysis of a prospective trial. , 2012, British journal of anaesthesia.

[52]  Phil Edwards,et al.  Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis , 2012, BMJ : British Medical Journal.

[53]  A. James,et al.  Postpartum hemorrhage: When uterotonics and sutures fail , 2012, American journal of hematology.

[54]  J. Strong,et al.  UK guidelines on the management of iron deficiency in pregnancy , 2012, British journal of haematology.

[55]  N. Milman Postpartum anemia II: prevention and treatment , 2012, Annals of Hematology.

[56]  L. Shields,et al.  Comprehensive maternal hemorrhage protocols improve patient safety and reduce utilization of blood products. , 2011, American journal of obstetrics and gynecology.

[57]  G. Liumbruno,et al.  Intraoperative cell salvage in obstetrics: is it a real therapeutic option? , 2011, Transfusion.

[58]  N. Milman Postpartum anemia I: definition, prevalence, causes, and consequences , 2011, Annals of Hematology.

[59]  S. Susen,et al.  High-dose tranexamic acid reduces blood loss in postpartum haemorrhage , 2011, Critical care.

[60]  P. Collins,et al.  Standard haemostatic tests following major obstetric haemorrhage. , 2011, International journal of obstetric anesthesia.

[61]  Ognjen Gajic,et al.  Incidence and transfusion risk factors for transfusion‐associated circulatory overload among medical intensive care unit patients , 2011, Transfusion.

[62]  Z. Alfirevic,et al.  Uterine Compression Sutures for the Management of Severe Postpartum Hemorrhage , 2011, Obstetrics and gynecology.

[63]  B. Ickx Fluid and blood transfusion management in obstetrics , 2010, European journal of anaesthesiology.

[64]  K. Bergmann,et al.  Prevalence and risk factors for early postpartum anemia. , 2010, European journal of obstetrics, gynecology, and reproductive biology.

[65]  M. Berman,et al.  The Epidemiology of Postpartum Hemorrhage in a Large, Nationwide Sample of Deliveries , 2010, Anesthesia and analgesia.

[66]  D. Elbourne,et al.  The WOMAN Trial (World Maternal Antifibrinolytic Trial): tranexamic acid for the treatment of postpartum haemorrhage: an international randomised, double blind placebo controlled trial , 2010, Trials.

[67]  C. Berg,et al.  Trends in postpartum hemorrhage: United States, 1994-2006. , 2010, American journal of obstetrics and gynecology.

[68]  J. V. van Roosmalen,et al.  Peripartum hysterectomy and arterial embolization for major obstetric hemorrhage: a 2-year nationwide cohort study in the Netherlands. , 2010, American journal of obstetrics and gynecology.

[69]  C. Berg,et al.  Trends in postpartum hemorrhage in high resource countries: a review and recommendations from the International Postpartum Hemorrhage Collaborative Group , 2009, BMC pregnancy and childbirth.

[70]  J. Isbister,et al.  Patient blood management – a new paradigm for transfusion medicine? , 2009, ISBT science series.

[71]  W. Martini Coagulopathy by hypothermia and acidosis: mechanisms of thrombin generation and fibrinogen availability. , 2009, The Journal of trauma.

[72]  W. Callaghan,et al.  Hypertensive Disorders and Severe Obstetric Morbidity in the United States , 2009, Obstetrics and gynecology.

[73]  P. Rhee,et al.  Impact of plasma transfusion in massively transfused trauma patients. , 2009, The Journal of trauma.

[74]  Samuel F Posner,et al.  Severe Obstetric Morbidity in the United States: 1998–2005 , 2009, Obstetrics and gynecology.

[75]  C. J. Nagy,et al.  Acute Normovolemic Hemodilution, Intraoperative Cell Salvage, and PulseCO Hemodynamic Monitoring in a Jehovahʼs Witness With Placenta Percreta , 2008 .

[76]  N. Milman Prepartum anaemia: prevention and treatment , 2008, Annals of Hematology.

[77]  C. Wade,et al.  The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital. , 2007, The Journal of trauma.

[78]  M. Druzin,et al.  How we treat: management of life‐threatening primary postpartum hemorrhage with a standardized massive transfusion protocol , 2007, Transfusion.

[79]  NN Mahajan,et al.  Internal iliac artery ligation for arresting postpartum haemorrhage , 2007, BJOG : an international journal of obstetrics and gynaecology.

[80]  N. Moss,et al.  Drape estimation vs. visual assessment for estimating postpartum hemorrhage , 2006, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[81]  D. Skupski,et al.  Improving Hospital Systems for the Care of Women With Major Obstetric Hemorrhage , 2006, Obstetrics and gynecology.

[82]  M. Ford,et al.  Postpartum curettage: An audit of 200 cases , 2005, The Australian & New Zealand journal of obstetrics & gynaecology.

[83]  N. McDonald Early thoughts on ‘Why Mothers Die 2000–2002’ , 2005, Anaesthesia.

[84]  P. Clyburn Early thoughts on ‘Why Mothers Die 2000–2002’ , 2004, Anaesthesia.

[85]  F. Smaill,et al.  Antibiotic regimens for endometritis after delivery. , 2004, The Cochrane database of systematic reviews.

[86]  S. Higgins,et al.  Prophylactic ergometrine-oxytocin versus oxytocin for the third stage of labour. , 2004, The Cochrane database of systematic reviews.

[87]  J. Alexander,et al.  Treatments for secondary postpartum haemorrhage. , 2002, The Cochrane database of systematic reviews.

[88]  D. L. Berry,et al.  NORMOVOLEMIC HEMODILUTION BEFORE CESAREAN HYSTERECTOMY FOR PLACENTA PERCRETA , 1997, Obstetrics and gynecology.

[89]  A. Coker,et al.  The B‐Lynch surgical technique for the control of massive postpartum haemorrhage: an alternative to hysterectomy? Five cases reported , 1997, British journal of obstetrics and gynaecology.

[90]  S. Cox,et al.  Serum Erythropoietin Quantitation in Pregnancy Using an Enzyme-Linked Immunoassay , 1992, American journal of perinatology.

[91]  F Hytten,et al.  Blood Volume Changes in Normal Pregnancy , 1985, Clinics in haematology.

[92]  W. Herbert,et al.  Management of Postpartum Hemorrhage , 1984, Clinical obstetrics and gynecology.

[93]  J. O'leary,et al.  Uterine Artery Ligation for Control of Postcesarean Section Hemorrhage , 1974, Obstetrics and gynecology.

[94]  J. O'leary,et al.  Uterine artery ligation in the control of intractable postpartum hemorrhage. , 1966, American journal of obstetrics and gynecology.

[95]  J. Duncan,et al.  Gynecologists , 1879, Atlanta medical and surgical journal.

[96]  A. Caughey,et al.  Practice Bulletin No. 183: Postpartum Hemorrhage. , 2017, Obstetrics and gynecology.

[97]  R. Dutton,et al.  Massive Transfusion Protocols: A Survey of Academic Medical Centers in the United States , 2017, Anesthesia and analgesia.

[98]  P. Meybohm,et al.  Patient Blood Management Bundles to Facilitate Implementation. , 2017, Transfusion medicine reviews.

[99]  R. Tufano,et al.  Coagulopathy induced by acidosis, hypothermia and hypocalcaemia in severe bleeding. , 2015, Minerva anestesiologica.

[100]  M. Cowie National Institute for Health and Care Excellence. , 2015, European heart journal.

[101]  S. Samal,et al.  Ferric carboxymaltose: A revolution in the treatment of postpartum anemia in Indian women , 2015, International journal of applied & basic medical research.

[102]  A. D’Alfonso,et al.  Intrauterine balloon tamponade as management of postpartum haemorrhage and prevention of haemorrhage related to low-lying placenta. , 2012, Clinical and experimental obstetrics & gynecology.

[103]  F. Viteri,et al.  Daily oral iron supplementation during pregnancy. , 2012, The Cochrane database of systematic reviews.

[104]  K. Louis,et al.  Postpartum Hemorrhage : Prevention and Treatment , 2008 .

[105]  E. McLean,et al.  Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia. , 2008 .

[106]  L. Stehling,et al.  Acute normovolemic hemodilution. , 2000, Journal of clinical anesthesia.

[107]  B. R. Holloway,et al.  Recommendations to Prevent and Control Iron Deficiency in the United States , 2022 .

[108]  40026386 Return Undeliverable,et al.  Canadian Agency for Drugs and Technologies in Health , 2009 .