{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T01:59:37Z","timestamp":1783475977577,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,12,18]],"date-time":"2015-12-18T00:00:00Z","timestamp":1450396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009033","name":"NHS Blood and Transplant","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009033","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Understanding the coagulopathy of major\u2010obstetric\u2010haemorrhage (<jats:styled-content style=\"fixed-case\">MOH<\/jats:styled-content>) that leads to massive\u2010transfusion (<jats:styled-content style=\"fixed-case\">MT<\/jats:styled-content>) is fundamental to improving outcomes. This study reports on the haematological features and transfusion management of women experiencing <jats:styled-content style=\"fixed-case\">MT<\/jats:styled-content> [defined as transfusion of \u22658 units of red blood cells (<jats:styled-content style=\"fixed-case\">RBC<\/jats:styled-content>) within 24\u00a0h of delivery]. One hundred and eighty\u2010one cases [median (interquartile range; <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>) age 33\u00a0years (29\u201336)] were identified from all <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> hospitals, using the <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> Obstetric Surveillance System between July 2012 and June 2013. The median (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>) estimated blood loss was 6\u00a0l (4\u00b75\u20138). At presentation, the median platelet count was lowest for placenta accreta, compared with other causes, while the median prothrombin time and fibrinogen were &lt;1\u00b75\u00a0\u00d7\u00a0mean normal and &lt;3\u00a0g\/l, respectively for all aetiologies. Median platelet count and fibrinogen fell to &lt;75\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/l and &lt;2\u00a0g\/l, respectively for all causes during bleeding, except for trauma. The median (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>) units of <jats:styled-content style=\"fixed-case\">RBC<\/jats:styled-content>, fresh\u2010frozen\u2010plasma (<jats:styled-content style=\"fixed-case\">FFP<\/jats:styled-content>) and cryoprecipitate transfused were 10 (8\u201314), 6 (4\u20138) and 2 (2\u20134), respectively. The median time from the onset of bleeding to delivery of the first <jats:styled-content style=\"fixed-case\">RBC<\/jats:styled-content> unit was significantly shorter for women who delivered via elective caesarean section, compared with others. The coagulopathy of <jats:styled-content style=\"fixed-case\">MT<\/jats:styled-content> during <jats:styled-content style=\"fixed-case\">MOH<\/jats:styled-content> differs significantly depending on its cause, suggesting that more targeted transfusion strategies are required.<\/jats:p>","DOI":"10.1111\/bjh.13864","type":"journal-article","created":{"date-parts":[[2015,12,19]],"date-time":"2015-12-19T01:04:01Z","timestamp":1450487041000},"page":"616-624","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":71,"title":["The haematological features and transfusion management of women who required massive transfusion for major obstetric haemorrhage in the <scp>UK<\/scp>: a population based study"],"prefix":"10.1111","volume":"172","author":[{"given":"Laura","family":"Green","sequence":"first","affiliation":[{"name":"Barts Health NHS Trust &amp; NHS Blood and Transplant London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian","family":"Knight","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Seeney","sequence":"additional","affiliation":[{"name":"Statistics and Clinical Studies NHS Blood and Transplant Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"Hopkinson","sequence":"additional","affiliation":[{"name":"Statistics and Clinical Studies NHS Blood and Transplant Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter W.","family":"Collins","sequence":"additional","affiliation":[{"name":"Arthur Bloom Haemophilia Centre Cardiff University Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel E.","family":"Collis","sequence":"additional","affiliation":[{"name":"Department of Anaesthetics Cardiff and Vale University Health Board Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel A. B.","family":"Simpson","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Weeks","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon J.","family":"Stanworth","sequence":"additional","affiliation":[{"name":"NHS Blood and Transplant Oxford &amp; Oxford University Hospitals NHS Trust Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,12,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2006.00891.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12605"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181d74898"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2007.02297.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-04-567891"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes096"},{"key":"e_1_2_10_8_1","unstructured":"Healthcare Improvement Scotland. 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