{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T23:13:58Z","timestamp":1778109238416,"version":"3.51.4"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","funder":[{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality. Little is known about transfusion practices in patients requiring blood tansfusions following cesarean delivery. The objective of this study is to describe the use of blood products, clotting factors, colloids, and antifibrinolytics in a contemporary cohort of patients with hemorrhage during cesarean and compare blood product use with a historic cohort of patients with a similar diagnosis.<\/jats:p>\n                  <jats:p>Secondary analysis of a multicenter trial of tranexamic acid versus placebo to prevent PPH during cesarean delivery. Patients with qualitative estimated intraoperative blood loss (EBL) of more than 1\u2009L were included in this analysis. Variables analyzed included transfusion of blood products, ratio of transfused packed red blood cell (PRBC) to fresh frozen plasma (FFP) and platelets, and use of clotting factors, anti-fibrinolytics, and colloids. Transfusion strategies were also compared with a historic cohort from the APEX study.<\/jats:p>\n                  <jats:p>Of the 707 (7.7%) who had EBL of greater than 1 liter, packed red cells were transfused in 21.1%, FFP in 5.4%, platelets in 2.4%, and cryoprecipitate in 2.3%. Among patients who received both PRBC and FFP, three quarters had a PRBC:FFP ratio between 1:1 and 2:1. Patients receiving both PRBC and platelets had a 1:1 ratio or less in 76.5% of cases. Clotting factor concentrates were not used in any case. Albumin was administered in 10.2% of cases. When compared with the historic cohort with an EBL\u2009&gt;\u20091\u2009L during cesarean, no differences in the use of blood products was noted.<\/jats:p>\n                  <jats:p>1 in 5 patients with intraoperative EBL\u2009&gt;\u20091\u2009L received PRBC transfusion. The use of other blood products was rare. There was no difference in transfusion strategies overtime when compared with a similar historic cohort. Obstetrical hemorrhage in patients undergoing cesarean delivery rarely involves intensive transfusion therapy.<\/jats:p>","DOI":"10.1055\/a-2859-5641","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T23:05:12Z","timestamp":1776985512000},"source":"Crossref","is-referenced-by-count":0,"title":["Blood Product Use for Hemorrhage during Cesarean Delivery"],"prefix":"10.1055","author":[{"given":"Luis D.","family":"Pacheco","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven J.","family":"Weiner","sequence":"additional","affiliation":[{"name":"Biostatistics Center, The George Washington University, Washington, District of Columbia, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George R.","family":"Saade","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca G.","family":"Clifton","sequence":"additional","affiliation":[{"name":"Biostatistics Center, The George Washington University, Washington, District of Columbia, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Parry","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"John M.","family":"Thorp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Longo","sequence":"additional","affiliation":[{"name":"Division of Extramural Research, Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Salazar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan T.N.","family":"Tita","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia","family":"Gyamfi-Bannerman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Columbia University, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suneet P.","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torri D.","family":"Metz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kara","family":"Rood","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dwight J.","family":"Rouse","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Brown University, Providence, Rhode Island, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Bailit","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William A.","family":"Grobman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyagriv N.","family":"Simhan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George A.","family":"Macones","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas at Austin, Austin, Texas, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units (MFMU) Network","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"e626","DOI":"10.1016\/S2214-109X(24)00560-6","article-title":"Global and regional causes of maternal deaths 2009-20: a WHO systematic analysis","volume":"13","author":"J A Cresswell","year":"2025","journal-title":"Lancet Glob Health"},{"key":"ref2","volume-title":"Pregnancy-related deaths: data from 14 U.S. 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