Platelet count and transfusion requirements during moderate or severe postpartum haemorrhage
Abstract
Limited data exist on platelet transfusion during postpartum haemorrhage. We retrospectively analysed a consecutive cohort from a single centre of 347 women with moderate or severe postpartum haemorrhage, transfused according to national guidelines. Twelve (3%) women required a platelet transfusion. There were no differences between women who did and did not receive platelets with respect to age, mode of initiation of labour or mode of delivery. Women receiving a platelet transfusion had a lower median (IQR [range]) platelet count at study entry than women who did not receive platelets before haemorrhage (135 (97-175 [26-259])×10(9) .l(-1) vs 224 (186-274 [91-1006])×10(9) .l(-1) ), respectively), and at diagnosis of postpartum haemorrhage (median 114 (78-153 [58-238])×10(9) .l(-1) vs 193 (155-243 [78-762])×10(9) .l(-1) respectively). Six women were thrombocytopenic pre-delivery. The cause of haemorrhage that was associated with the highest rate of platelet transfusion was placental abruption, with three of 14 women being transfused. If antenatal thrombocytopenia or consumptive coagulopathy were not present, platelets were only required for haemorrhage > 5000 ml. Early formulaic platelet transfusion would have resulted in many women receiving platelets unnecessarily. Using current guidelines, the need for platelet transfusion is uncommon without antenatal thrombocytopenia, consumptive coagulopathy or haemorrhage > 5000 ml. We found no evidence to support early fixed-ratio platelet transfusion.
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Compared to other causes of obstetrical hemorrhage, pregnant people with significant abruption experience greater decreases in platelets, require more platelet transfusions, and have more acquired hypofibrinogenemia.
“Compared to other causes of obstetrical hemorrhage, pregnant people with significant abruption experience greater decreases in platelets, require more platelet transfusions, and have more acquired hypofibrinogenemia (95–97).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [96]
The Summary reports that placental abruption had the highest platelet-transfusion rate (3/14, 21%). The Discussion says all abruption cases requiring platelets also had severe hypofibrinogenemia, but it does not establish that hypofibrinogenemia was more common across all abruption cases than with other causes. The retrieved Results do not establish that abruption caused greater decreases in platelet count than other causes. (LLM, conf=0.85)
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Cites
Global causes of maternal death: a WHO systematic analysis
Say, L., Chou, D., Gemmill, A., Tunçalp, Ö., Moller, A.-B., Daniels, J., Gülmezoglu, A. M., Temmerman, M., & Alkema, L. (2014) · The Lancet Global Health · doi:10.1016/s2214-109x(14)70227-x · Cited by 6,582 · see citing works
Holcomb, J. B., Tilley, B. C., Baraniuk, S., Fox, E. E., Wade, C. E., Podbielski, J. M., del Junco, D. J., Brasel, K. J., Bulger, E. M., Callcut, R. A., et al. (2015) · JAMA · doi:10.1001/jama.2015.12 · Cited by 2,533 · see citing works
Management of severe perioperative bleeding
Kozek‐Langenecker, S. A., Afshari, A., Albaladejo, P., Aldecoa, C., ROBERTIS, E. D., Filipescu, D. C., Fries, D. R., Görlinger, K., Haas, T., Imberger, G. L., et al. (2013) · European Journal of Anaesthesiology · doi:10.1097/eja.0b013e32835f4d5b · Cited by 900 · see citing works
The decrease of fibrinogen is an early predictor of the severity of postpartum hemorrhage
CHARBIT, B., MANDELBROT, L., SAMAIN, E., BARON, G., HADDAOUI, B., KEITA, H., SIBONY, O., MAHIEU‐CAPUTO, D., HURTAUD‐ROUX, M. F., HUISSE, M. G., et al. (2007) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2007.02297.x · Cited by 762 · see citing works
Knight, M. (2017) · National Perinatal Epidemiology Unit, University of Oxford · doi:10.5287/ora-nrymp8wxq · Cited by 541 · see citing works
Shields, L. E., Wiesner, S., Fulton, J., & Pelletreau, B. (2015) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2014.07.012 · Cited by 276 · see citing works
Collins, P. W., Lilley, G., Bruynseels, D., Laurent, D. B. S., Cannings-John, R. L., Precious, E., Hamlyn, V., Sanders, J., Alikhan, R., Rayment, R., et al. (2014) · Blood · doi:10.1182/blood-2014-04-567891 · Cited by 255 · see citing works
Self-citationA practical guideline for the haematological management of major haemorrhage
Hunt, B. J., Allard, S., Keeling, D. M., Norfolk, D. R., Stanworth, S. J., & Pendry, K. (2015) · British Journal of Haematology · doi:10.1111/bjh.13580 · Cited by 252 · see citing works
Evidence-Based Platelet Transfusion Guidelines
Slichter, S. J. (2007) · Hematology · doi:10.1182/asheducation-2007.1.172 · Cited by 248 · see citing works
Haemostatic monitoring during postpartum haemorrhage and implications for management
Solomon, C., Collis, R. E., & Collins, P. W. (2012) · British Journal of Anaesthesia · doi:10.1093/bja/aes361 · Cited by 214 · see citing works
Self-citationMallaiah, S., Barclay, P., Harrod, I., Chevannes, C., & Bhalla, A. (2015) · Anaesthesia · doi:10.1111/anae.12859 · Cited by 213 · see citing works
Standard haemostatic tests following major obstetric haemorrhage
de Lloyd, L., Bovington, R., Kaye, A., Collis, R. E., Rayment, R., Sanders, J., Rees, A., & Collins, P. W. (2011) · International Journal of Obstetric Anesthesia · doi:10.1016/j.ijoa.2010.12.002 · Cited by 213 · see citing works
Self-citationBlood transfusion and the anaesthetist: management of massive haemorrhage
Thomas, D., Wee, M. Y. K., Clyburn, P. A., WALKER, I. A., Brohi, K., Collins, P. W., Doughty, H. A., Isaac, J., Mahoney, P., & Shewry, L. (2010) · Anaesthesia · doi:10.1111/j.1365-2044.2010.06538.x · Cited by 188 · see citing works
Self-citationHaemostatic management of obstetric haemorrhage
Collis, R. E., & Collins, P. W. (2014) · Anaesthesia · doi:10.1111/anae.12913 · Cited by 185 · see citing works
Self-citationThachil, J., & Toh, C.-H. (2009) · Blood Reviews · doi:10.1016/j.blre.2009.04.002 · Cited by 177 · see citing works
Management of coagulopathy associated with postpartum hemorrhage: guidance from the SSC of the ISTH
Collins, P., Kadir, R. A., & Thachil, J. V. (2015) · Journal of Thrombosis and Haemostasis · doi:10.1111/jth.13174 · Cited by 151 · see citing works
Self-citationAhmed, S., Harrity, C., Johnson, S., Varadkar, S., McMorrow, S., Fanning, R., Flynn, C. M., O' Riordan, J. M., & Byrne, B. M. (2012) · Transfusion Medicine · doi:10.1111/j.1365-3148.2012.01178.x · Cited by 118 · see citing works
The pathophysiology of trauma-induced coagulopathy
Frith, D., & Brohi, K. (2012) · Current Opinion in Critical Care · doi:10.1097/mcc.0b013e3283599ab9 · Cited by 102 · see citing works
Green, L., Knight, M., Seeney, F., Hopkinson, C., Collins, P. W., Collis, R. E., Simpson, N. A. B., Weeks, A., & Stanworth, S. J. (2016) · British Journal of Haematology · doi:10.1111/bjh.13864 · Cited by 77 · see citing works
Self-citationSimon, L., Santi, T. M., Sacquin, P., et al. (1997) · British Journal of Anaesthesia · doi:10.1093/bja/78.6.678 · Cited by 66 · see citing works
An Observational Study of the Fresh Frozen Plasma
Pasquier, P., Gayat, É., Rackelboom, T., Rosa, J. L., Tashkandi, A., Tesnière, A., Ravinet, J., Vincent, J., Tsatsaris, V., Ozier, Y. M., et al. (2012) · Anesthesia & Analgesia · doi:10.1213/ane.0b013e31826f084d · Cited by 59 · see citing works
How we manage the haematological aspects of major obstetric haemorrhage
Allard, S., Green, L., & Hunt, B. J. (2013) · British Journal of Haematology · doi:10.1111/bjh.12605 · Cited by 56 · see citing works
How I treat postpartum hemorrhage
Pavord, S. R., & Maybury, H. (2015) · Blood · doi:10.1182/blood-2014-10-512608 · Cited by 48 · see citing works
Levi, M. M. (2013) · Thrombosis Research · doi:10.1016/s0049-3848(13)70017-3 · Cited by 46 · see citing works
Blood component therapy in postpartum hemorrhage
James, A., Paglia, M. J., Gernsheimer, T., et al. (2009) · Transfusion · doi:10.1111/j.1537-2995.2009.02318.x · Cited by 45 · see citing works
McNamara, H., Mallaiah, S., Barclay, P., Chevannes, C., & Bhalla, A. (2014) · International Journal of Obstetric Anesthesia · doi:10.1016/j.ijoa.2014.12.005 · Cited by 43 · see citing works
The Role of Massive Transfusion Protocols in Obstetrics
Pacheco, L. D., Saade, G. A., Costantine, M. M., et al. (2012) · American Journal of Perinatology · doi:10.1055/s-0032-1322511 · Cited by 38 · see citing works
Transfusion practices in postpartum hemorrhage: a population‐based study
Bonnet, M., Deneux‐Tharaux, C., Dupont, C., Rudigoz, R.-C., & Bouvier‐Colle, M. (2012) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.12063 · Cited by 38 · see citing works
Transfusion practice in major obstetric haemorrhage: lessons from trauma
Saule, I., & Hawkins, N. (2011) · International Journal of Obstetric Anesthesia · doi:10.1016/j.ijoa.2011.09.009 · Cited by 38 · see citing works
Postpartum hemorrhage management in 2012: Predicting the future
Onwuemene, O. A., Green, D., & Keith, L. (2012) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2012.07.001 · Cited by 38 · see citing works
Mallaiah, S., Chevannes, C., McNamara, H., et al. (2015) · Anaesthesia · doi:10.1111/anae.13128 · Cited by 22 · see citing works
Effect of thrombocytopenia on mode of analgesia/anesthesia and maternal and neonatal outcomes
Dikman, D., Elstein, D., Levi, G. S., et al. (2013) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.3109/14767058.2013.836483 · Cited by 9 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- [27]27. Mallaiah S, Chevannes C, McNamara H, Barclay P. Use of ROTEM® in major obstetric haemorrhage. Anaesthesia 2015; 70: 760-1.
- [29]29. Lilley GJ, Collis RE. Gravimetric measurement of blood loss versus visual estimation in simulated postpartum haemorrhage. International Journal of Obstetric Anesthesia 2013; 22: S10.
Cited by
Sorted by citations
Brandt, J. S., & Ananth, C. V. (2023) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.06.059 · Cited by 115 · see citing works
Bell, S. F., Roberts, T. C. D., Freyer Martins Pereira, J., De Lloyd, L., Amir, Z., James, D., Jenkins, P. V., Collis, R. E., & Collins, P. W. (2022) · International Journal of Obstetric Anesthesia · doi:10.1016/j.ijoa.2021.103238 · Cited by 52 · see citing works
- Authors
- Jones, R. M., de Lloyd, L., Kealaher, E. J., Lilley, G. J., Precious, E., Burckett st Laurent, D., Hamlyn, V., Collis, R. E., Collins, P. W., & collaborators
- Affiliations
- Cardiff and Vale University Health Board (GB)
- Department of Anaesthetics and Pain Control Cardiff and Vale University Health Board Cardiff UK
- Cardiff University (GB)
- Corresponding author
- Collins, P. W.
- Venue
- Anaesthesia
- Publisher
- Wiley
- Published
- 2016-04-06
- Volume
- 71
- Issue
- 6
- Pages
- 648-656
- ISSN
- 0003-2409 (ISSN-L)
- 1365-2044
- OpenAlex
- W2329251408
- Cited by
- 39
- References
- 32
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2023: 5 · 2022: 7 · 2021: 6 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 3 · 2016: 1
- FWCI
- 2.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Anaesthesia (publishedVersion)
- PubMed (publishedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Biochemistry › Blood transfusion and management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
- Keywords
- postpartum hemorrhage, platelet transfusion, platelet count, transfusion requirements, disseminated intravascular coagulation, placental abruption, obstetric blood transfusion
- MeSH terms
- Adolescent, Adult, Female, Postpartum Hemorrhage, Humans, Middle Aged, Platelet Count, Pregnancy, Retrospective Studies, Platelet Transfusion, Young Adult
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