An update on the use of massive transfusion protocols in obstetrics

Luis D. Pacheco, George R. Saade, Maged M. Costantine, Steven L. Clark, Gary D.V. Hankins

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


Obstetrical hemorrhage remains a leading cause of maternal mortality worldwide. New concepts involving the pathophysiology of hemorrhage have been described and include early activation of both the protein C and fibrinolytic pathways. New strategies in hemorrhage treatment include the use of hemostatic resuscitation, although the optimal ratio to administer the various blood products is still unknown. Massive transfusion protocols involve the early utilization of blood products and limit the traditional approach of early massive crystalloid-based resuscitation. The evidence behind hemostatic resuscitation has changed in the last few years, and debate is ongoing regarding optimal transfusion strategies. The use of tranexamic acid, fibrinogen concentrates, and prothrombin complex concentrates has emerged as new potential alternative treatment strategies with improved safety profiles.

Original languageEnglish (US)
Pages (from-to)340-344
Number of pages5
JournalAmerican journal of obstetrics and gynecology
Issue number3
StatePublished - Mar 1 2016


  • hemostatic resuscitation
  • massive transfusion
  • obstetrical hemorrhage

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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