Skip to main content
SMFM 2025 Pregnancy Meeting Main banner
Final Program


Program Book
Icon Legend
Presentation Icons
Additional registration fee required
Additional registration fee required
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Poster Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Back

Poster Session 1

(132) Whole blood in the management of postpartum hemorrhage

Thursday, January 30, 2025
10:30 AM – 12:30 PM  
Objective: Although whole blood (WB) has been shown to improve outcomes in acute trauma patients, it is not widely available in many institutions. The objective of this study was to examine maternal outcomes in those receiving WB versus packed red blood cells with multiple blood products to reconstitute whole blood for postpartum hemorrhage (PPH).

Study Design: This was a prospective cohort study of patients undergoing vaginal delivery complicated by uterine atony who received transfusion within the first 2 hours after delivery at a large, academic facility. As an institutional practice, WB is preferentially ordered for PPH, however, when unavailable, a combination of packed red blood cells (PRBC) and fresh frozen plasma (FFP) is provided by transfusion services as a substitute. Data was collected by dedicated, trained research nurses in coordination with transfusion services. Statistical analysis included chi-square with P< 0.05 considered significant.

Results: Between Jan 2019 and Nov 2023, there were 119 patients meeting inclusion criteria. As shown in the Table, there were no significant differences in demographics or time from order to transfusion (P=0.26) among the study cohort. Estimated blood loss was lower in the WB group: (1875 [1250,2500] mL vs 1250 [1000,1750] mL, P=0.01). Compared to patients receiving multi-component therapy without WB, those who received WB required significantly fewer total blood products (2 [2,2] vs 6 [4,7], P< 0.001) and required an operative procedure less frequently (15.8% vs 42.9%, P=0.04). There was a trend for less febrile morbidity and acute renal insufficiency with use of WB compared to use of multi-component therapy.

Conclusion: The Alliance for Innovation on Maternal Health advocates for early recognition and treatment of PPH. Compared to the use of PRBC and FFP, the use of WB reduces the need for large-volume ( >4 units) blood product transfusion and need for operative intervention, in the setting of PPH due to uterine atony within the first 2 hours following delivery.  Whole blood, if available, should be the preference for resuscitation in such cases.